SFEIES24 Poster Presentations Diabetes & Metabolism (68 abstracts)
1Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland; 2Technical University Dublin, Dublin, Ireland; 3Connolly Hospital, Dublin, Ireland
Chronic ulcers represent very common and serious complications of diabetes mellitus. Their persistence leads to repeated infections, often leading to amputation. The current state-of-the art treatment includes debridement which is aimed at preparing the wound bed and stimulating ulcer edges to trigger tissue regeneration. We aimed to test the hypothesis that features of the debrided tissue may be indicative of the natural evolution of the wound. As a first step for this characterization we examined, histologically, debrided tissue of 18 ulcers from 13 different people attending the podiatry clinic at Connolly Hospital for routine care of diabetes-related ulcers. Patients gave informed consent to the examination and this project was granted approval by the Connolly Hospital Ethics Committee. Samples were fixed in formalin immediately after collection and transferred to the Tissue Engineering Research Group Laboratory of RCSI for histological processing and analysis. Paraffin sections of 7 microns were prepared, stained with haematoxylin-eosin and examined using light microscopy. From a first analysis of these samples it appeared that, in general, all contained epithelial rests where tissue was clumped and appeared necrotic. In 2 samples a clear strong inflammatory infiltrate was observed, and in another a small area of cells presumed to represent inflammatory infiltrate was seen. Interestingly, in 4 of the samples, in addition to obviously necrotic clumps of tissue, it was possible to identify epidermal rests that resembled viable or normal tissue in appearance. However, we did not identify a specific correlation between these findings and clinical features suggestive of ulcers that were less severe or healing better. More detailed investigation of a larger number of samples with longer clinical follow up of the ulcers over time may provide additional insight into this important question.