Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size
Background: Patients with diabetes are at an increased risk of developing chronic adverse events owing to diabetes-associated complications. Diabetic foot ulcers (DFUs) occur in approximately 15% of all diabetic patients. Patients with larger wound sizes and increasing age are often excluded from cl...
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Elsevier
2025-01-01
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| Series: | JVS-Vascular Insights |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949912725000327 |
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| author | Weiying Lu, BS Min Hu, MSW Zheng Zhang, ME John Slaughter, MS Anil Hingorani, MD Alisha Oropallo, MD |
| author_facet | Weiying Lu, BS Min Hu, MSW Zheng Zhang, ME John Slaughter, MS Anil Hingorani, MD Alisha Oropallo, MD |
| author_sort | Weiying Lu, BS |
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| description | Background: Patients with diabetes are at an increased risk of developing chronic adverse events owing to diabetes-associated complications. Diabetic foot ulcers (DFUs) occur in approximately 15% of all diabetic patients. Patients with larger wound sizes and increasing age are often excluded from clinical trials. Methods: A meta-analysis to compare the complete wound healing rates of patients receiving cellular and acellular matrix products (CAMPs) with standard of care (SOC) and with SOC alone was conducted. A total of 29 randomized controlled trials involving 2255 patients with DFU were included in the meta-analysis. Results: The results indicated that the complete healing rate for CAMPs plus SOC patients was higher than for patients receiving SOC only. The aggregated odds ratio is 2.9 (95% confidence interval, 2.3-3.8). Patients in the CAMPs plus SOC group were almost three times more likely to achieve 100% wound closure than those treated with SOC only through final follow-up in each study. The median follow-up duration across studies was 12 weeks (Q1-Q3: 12-16 weeks), with no significant differences in follow-up length between the two arms. Conclusions: Patients receiving CAMPs for DFUs were more likely to achieve wound closure. Meta-regression analysis of the moderators indicated that both moderators, average patient age and average wound size (baseline), displayed a nonsignificant relationship to the main outcome of wound closure. These findings suggest that patient age and wound size should not be excluded from clinical trials. |
| format | Article |
| id | doaj-art-2e3c2c8475fa40ce85cca772fe9f4b7b |
| institution | OA Journals |
| issn | 2949-9127 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | JVS-Vascular Insights |
| spelling | doaj-art-2e3c2c8475fa40ce85cca772fe9f4b7b2025-08-20T02:01:28ZengElsevierJVS-Vascular Insights2949-91272025-01-01310021510.1016/j.jvsvi.2025.100215Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound sizeWeiying Lu, BS0Min Hu, MSW1Zheng Zhang, ME2John Slaughter, MS3Anil Hingorani, MD4Alisha Oropallo, MD5Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Uniondale, NYSchool of Social Work, State University of New York, University at Buffalo, Buffalo, NYTeachers College, Columbia University, New York, NYDepartment of Counseling, School and Educational Psychology, State University of New York, University at Buffalo, Buffalo, NYDepartment of Surgery, NYU Grossman School of Medicine, New York, NYDepartment of Vascular Surgery, Zucker School of Medicine, Hofstra University/Northwell Health, Lake Success, NY; Correspondence: Alisha Oropallo, MD, Zucker School of Medicine, Hofstra University/Northwell Health, Department of Vascular Surgery, 1999 Marcus Ave Ste M6, Lake Success, NY 11042Background: Patients with diabetes are at an increased risk of developing chronic adverse events owing to diabetes-associated complications. Diabetic foot ulcers (DFUs) occur in approximately 15% of all diabetic patients. Patients with larger wound sizes and increasing age are often excluded from clinical trials. Methods: A meta-analysis to compare the complete wound healing rates of patients receiving cellular and acellular matrix products (CAMPs) with standard of care (SOC) and with SOC alone was conducted. A total of 29 randomized controlled trials involving 2255 patients with DFU were included in the meta-analysis. Results: The results indicated that the complete healing rate for CAMPs plus SOC patients was higher than for patients receiving SOC only. The aggregated odds ratio is 2.9 (95% confidence interval, 2.3-3.8). Patients in the CAMPs plus SOC group were almost three times more likely to achieve 100% wound closure than those treated with SOC only through final follow-up in each study. The median follow-up duration across studies was 12 weeks (Q1-Q3: 12-16 weeks), with no significant differences in follow-up length between the two arms. Conclusions: Patients receiving CAMPs for DFUs were more likely to achieve wound closure. Meta-regression analysis of the moderators indicated that both moderators, average patient age and average wound size (baseline), displayed a nonsignificant relationship to the main outcome of wound closure. These findings suggest that patient age and wound size should not be excluded from clinical trials.http://www.sciencedirect.com/science/article/pii/S2949912725000327Diabetic foot ulcerDiabetesMatrixSkin substituteCellular |
| spellingShingle | Weiying Lu, BS Min Hu, MSW Zheng Zhang, ME John Slaughter, MS Anil Hingorani, MD Alisha Oropallo, MD Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size JVS-Vascular Insights Diabetic foot ulcer Diabetes Matrix Skin substitute Cellular |
| title | Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| title_full | Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| title_fullStr | Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| title_full_unstemmed | Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| title_short | Meta-analysis of cellular and acellular tissue-based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| title_sort | meta analysis of cellular and acellular tissue based products demonstrates improvement of diabetic foot ulcer healing despite age and wound size |
| topic | Diabetic foot ulcer Diabetes Matrix Skin substitute Cellular |
| url | http://www.sciencedirect.com/science/article/pii/S2949912725000327 |
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