Autologous fibroblast suspension for the treatment of refractory diabetic foot ulcer

eripheral neuropathy, are regarded as serious complications of diabetes mellitus.[1] At least 15% of diabetic patients may be affected by diabetic foot ulcer over their lifetime. One recent case series showed that in vitro expanded fibroblasts were a satisfactory therapeutic option to treat large leg ulcers in patients with diabetes. Our patient was a 62-year-old man who had diabetes mellitus for 30 years. Following contact with a hot metal, he developed a large ulcer of dimensions 9.93 × 9.09 cm with an area of 67.960 cm 2 and a depth of 4 mm (stage B, grade 2) on the medial surface of his right foot. Diameters, area and depth of the ulcer were determined by Pictzar software before and 4 months after treatment. Despite classic diabetic wound care for the patient which included off-loading, surgical debridement, topical and oral antibiotic treatment (including ciprofloxacin 500 mg, twice daily and clindamycin 300 mg, thrice daily) and glycemic control, no sign of improvement was observed after 6 weeks. The stage and grade of the wound was defined according to University of Texas wound classification system. The wound infection score was based on the system from Knighton et al., as modified by Pecoraro et al