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Table 2: Clinical result
Patient Ulcer Location Wagner Infection* t0 Infection end Dimension Dimension WBS t0 WBS Percentage Time
ulcer t0 end end wound healing
classification reduction (days)
1 #1 Leg 1 Absent Absent 12.6 0 6 16 100 40
2 #2 Leg 1 Mild Sev 33.82 34.09 7 16 −1 -
(S. epidermidis) (P. aeruginosa)
3 #3 Ankle 2 Absent Absent 11.31 0.8 10 16 93 -
#4 Leg 1 Absent Absent 28.91 15.01 9 16 48
#5 Leg 1 Absent Absent 6.03 2.44 9 16 60
4 #6 Ankle 2 Mild (S. aureus) Absent 21.32 19.27 8 10 10 -
#7 Ankle 1 Absent Absent 22.68 1.78 7 16 92
5 #8 Ankle 1 Severe (E. coli) Mild (E. coli) 15.68 8.41 3 5 46 -
6 #9 Leg 1 Absent Absent 3 0 12 16 100 21
7 #10 Ankle 1 Moderate Absent 19.65 1.35 9 12 93 -
(P. aeruginosa)
#11 Leg 1 Moderate Absent 22.7 6.93 8 15 69
(S. epidermidis)
8 #12 Ankle 1 Mild Absent 8.55 2.28 16 16 73
(P. aeruginosa)
9 #13 Leg 1 Absent Absent 4.85 0 14 16 100 40
10 #14 Ankle 1 Absent Absent 11.78 0 9 16 100 70
#15 Ankle 1 Absent Absent 3.08 0 16 16 100 40
11 #16 Leg 1 Absent Absent 4.07 0 11 16 100 45
Mean 14.37 5.77 9.62 14.62 70 42.66
Ds 9.29 9.52 3.51 3.09 32 15.75
Maximum 33.82 34.09 16 16 100 70
Minimum 3 0 3 5 −1 21
P value 0.0007 <0.0001
*Local infection was considered divided into four progressive grades (absent/mild/moderate/severe) based on the results of cultural swabs.
S. epidermidis: Staphylococcus epidermidis, S. aureus: Staphylococcus aureus, E. coli: Escherichia coli, P. aeruginosa: Pseudomonas aeruginosa, WBS: wound bed score

Figure 1: Diabetic ulcer of the ankle of 3 cm × 4 cm Figure 2: Intraoperative application of the allogeneic sheet on the
wound
growth factors and extracellular matrix proteins, and to
attract differentiated or stem cells in the wound milieu. [15] therapies or surgical indications, thereby allowing the
closure of nonhealing chronic ulcers, and thus reducing
This clinical case‑series study based on the utilization morbidity, cost, and length of hospitalization. Allogeneic
of new cultured allogeneic keratinocyte sheets showed skin substitutes do not require prolonged operating time
promising results, including safety and tolerability or skin biopsy, and are easily applied by the surgeon in
of the allogeneic product, good wound healing
rate, a great reduction in wound size in a relatively contrast to flaps or autograft. In the multidisciplinary
short period, and preparation of the wound bed for approach to diabetic chronic wounds, allogeneic skin
alternative reconstructive treatments (i.e. split‑thickness substitutes on a hyaluronic acid scaffold may represent
autograft). The application of allogeneic keratinocytes a valid alternative when other possibilities have been
on a hyaluronic acid scaffold may allow improvement exhausted. Keratinocyte sheets were also applied when
of diabetic leg and foot lesions not amenable to other mild to moderate local infection was present, resulting

Plast Aesthet Res || Vol 1 || Issue 2 || Sep 2014 77