Long-Term Clinical and Radiologic Evaluation of Micronized Acellular Dermal Matrix-Assisted Reconstruction in Diabetes-Related and Traumatic Foot Wounds With Bone Defects.

To investigate whether micronized acellular dermal matrix (mADM) can be used to treat diabetes-related and traumatic foot wounds with bone defects after bone or joint resection. We retrospectively reviewed 52 patients who underwent bone or joint resection, followed by mADM-assisted reconstruction of diabetes-related or traumatic foot wounds between 2021 and 2024. mADM was applied using sheet-type, paste-type or combined formulations in one- or multi-stage procedures. Wound healing, contour preservation and radiological alignment were assessed. Among the 52 patients (43 with diabetes and 9 with trauma), complete epithelialization was achieved in 48 (mean follow-up: 14.8 months; mean time to wound closure: 5.6 weeks). Four cases showed recurrence or delayed healing and five developed mild early local infection; all were controlled with additional wound care or antibiotics, with no progressive osteomyelitis or graft loss. In 40 radiologically evaluable cases, the toe length and alignment were generally preserved (mean toe length ratio: 91.6% and no angular deformity > 10°). mADM-assisted reconstruction may be useful for treating diabetes-related and traumatic foot wounds with bone defects after bone or joint resection. Its role appears to lie in dead-space management, contour preservation and durable wound coverage, rather than bone replacement.