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.
Keywords: cellular, acellular, and matrix-like products; diabetic foot ulcer; skin substitute; treatment outcomes; wound closure matrix; wound healing.