Preserving limbs and lives: the role of cellular, acellular, and matrix-like products in diabetic foot ulcer care.

BACKGROUND

Diabetic foot ulcers (DFUs) significantly affect patients and health care systems, often resulting in amputation and high morbidity.

OBJECTIVE

To evaluate whether cellular, acellular, and matrix-like products (CAMPs) are more effective than the standard of care in reducing lower limb amputation (LLA) risk and improving survival in DFU patients.

METHODS

This retrospective cohort study used a proprietary database to identify patients with type 1 or type 2 diabetes and foot ulcers. Two cohorts were compared: those receiving debridement and those receiving CAMPs. Propensity score matching (PSM) balanced baseline characteristics. The primary outcome was 5-year LLA risk and amputation-free survival.

RESULTS

Before PSM, the CAMPs cohort (n = 2273) had higher rates of comorbidities compared with the debridement-only cohort (n = 31,050). After matching, cohorts were well-balanced (n = 2272 each). Treatment with CAMPs significantly reduced the risk of LLA compared with debridement alone, with a 4.9% absolute risk reduction (95% CI, -7.4 to -2.4%; P < .0001) and a 24% relative risk reduction (risk ratio, 0.763; 95% CI, 0.664-0.876). Kaplan-Meier analysis demonstrated improved 5-year amputation-free survival in the CAMPs cohort (75.7% vs 71.3%).

CONCLUSION

CAMP therapy significantly reduces LLA risk and improves amputation-free survival in DFU patients.