Treatment of Recalcitrant Diabetic Ulcers with Trichloroacetic Acid and Fibroblasts; Case Report

Document Type : Case Report

Authors

1 Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Associate Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan AND Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Associate Professor, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

5 General Practitioner, Researcher, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

6 Assistant Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Foot ulcer, with a prevalence of 15% in general population, is one of the main complications in patients with diabetes. So far, different therapeutic methods have been provided for the treatment of foot ulcers. When no response to the standard treatment methods is observed, other methods would be applied.Case Report: In this report, we introduce two men with type 2 diabetes mellitus and recalcitrant diabetic foot ulcer who were treated with topical 50% trichloroacetic acid solvent and autologous fibroblasts. The treatment resulted in complete healing of foot ulcers in both patients.Conclusion: Trichloroacetic acid and autologous fibroblast can be considered as therapeutic choice for recalcitrant diabetic foot ulcer. 

Keywords

References

  1. Dalla PL, Faglia E. Treatment of diabetic foot ulcer: an overview strategies for clinical approach. Curr Diabetes Rev 2006; 2(4): 431-47.
  2. Aalami Harandi B, Aalami Harandi A, Siavashi B. Diabetic foot ulcer management review of literature. Iran J Surg 2009; 16(4): 1-7. [In Persian].
  3. Hinchliffe RJ, Valk GD, Apelqvist J, Armstrong DG, Bakker K, Game FL, et al. A systematic review of the effectiveness of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev 2008; 24(Suppl 1): S119-S144.
  4. Nilforoushzadeh MA, Jaffary F, Siavash M, Heidari A, Ansari N, Siadat AH. Treatment of Recalcitrant Diabetic Ulcers With Trichloroacetic Acid and Fibroblasts. J Skin Stem Cell 2014; 1(2 SP e23312).
  5. Lavery LA, Armstrong DG, Harkless LB. Classification of diabetic foot wounds. J Foot Ankle Surg 1996; 35(6): 528-31.
  6. Knighton DR, Ciresi KF, Fiegel VD, Austin LL, Butler EL. Classification and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF). Ann Surg 1986; 204(3): 322-30.
  7. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 293(2): 217-28.
  8. Margolis DJ, Allen-Taylor L, Hoffstad O, Berlin JA. Healing diabetic neuropathic foot ulcers: are we getting better? Diabet Med 2005; 22(2): 172-6.
  9. Nguyen TH, Rooney JA. Trichloroacetic acid peels. Dermatologic Therapy 2000; 13(2): 173-82.
  10. Nifroushzadeh MA, Jafary F, Reiszadeh MR. Comparative effect of topical trichloroacetic acid and intralesional meglumine antimoniate in the treatment of acute cutaneous leishmaniasis. Int J pharm 2006; 2(6): 633-6.
  11. Ulicna M, Danisovic L, Vojtassak J. Does cell therapy and tissue engineering represent a promising treatment of diabetic foot ulcers? Bratisl Lek Listy 2010; 111(3): 138-43.
  12. Marston WA, Hanft J, Norwood P, Pollak R. The efficacy and safety of Dermagraft in improving the healing of chronic diabetic foot ulcers: results of a prospective randomized trial. Diabetes Care 2003; 26(6): 1701-5.
  13. Wong T, McGrath JA, Navsaria H. The role of fibroblasts in tissue engineering and regeneration. Br J Dermatol 2007; 156(6): 1149-55.
  14. Gibbs S, van den Hoogenband HM, Kirtschig G, Richters CD, Spiekstra SW, Breetveld M, et al. Autologous full-thickness skin substitute for healing chronic wounds. Br J Dermatol 2006; 155(2): 267-74.
Journal of Isfahan Medical School
Volume 32, Issue 315 - Serial Number 315
November and December 2015
Pages 2252-2259

Files

History

  • Receive Date: 25 December 2014
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics