A Closer Look At Bioengineered Alternative Tissues

By Paul J. Kim, DPM, Karolina S. Dybowski, BS, and John S. Steinberg, DPM

   The medical management of wounds today is vastly different than wound management was a few years ago. Evidence-based research has provided the practitioner with new technologies that can predictably heal wounds that previously would have threatened limb loss.    The team approach to complex wound management has been widely embraced and many communities now have referral centers and hospital-based teams that provide multidisciplinary care. With an estimated 20.8 million people in the United States now affected by diabetes and a 15 percent lifetime incidence of foot ulceration in those diagnosed with diabetes, the public health impact of wound care is rapidly making its way into the spotlight. One can properly assume these concerns have a significant impact on the projection that Medicare is expected to be insolvent by the year 2018.    Recent advances in bioengineering have expanded the wound care treatment armamentarium with products that can stimulate healing where there was once a chronic or problem wound. However, the complexity and sheer number of bioengineered products now available for wounds has led to some confusion and hesitancy on the part of many physicians who contemplate their use. Clearly, there is no one perfect bioengineered product for all wounds. Accordingly, let us take a closer look at the current leading biotechnologies that clinicians may utilize for lower extremity wounds.

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