Acellular Porcine Dermal Matrix Wound Dressing in the Management of Diabetic Foot Ulcers

The primary objective of this study is to have ulcers completely healed by the Acellular
Porcine Dermal Matrix (APM) protocol in the management of indolent diabetic ulcers at 12
weeks.

Inclusion Criteria:

Inclusion Criteria and Population:

- Male or female age 18 or older

- Informed consent must be obtained

- Patient's ulcer must be diabetic in origin and larger than 1cm2. Debridement will be
done prior to randomization. Subject's informed consent for participating in this
study, must be obtained prior to proceeding with sharp debridement.

- Patients with Type 1 or Type 2 diabetes (criteria for the diagnosis of diabetes
mellitus per ADA).

- Patient's ulcer must exhibit no clinical signs of infection.

- Patient is of legal consenting age.

- Patient is willing to provide informed consent and is willing to participate in all
procedures and follow up evaluations necessary to complete the study.

- Patient has adequate circulation to the affected extremity, as demonstrated by one of
the following within the past 60 days:

- Dorsum transcutaneous oxygen test (TcPO2) with results ≥30mmHg, OR

- ABIs with results of ≥0.7 and ≤1.2, OR

- Doppler arterial waveforms,which are triphasicor biphasic at the ankle of
affected leg

Exclusion Criteria:

- Patients presenting with an ulcer probing to bone (UT Grade IIIA-D). A positive
probe-to-bone will be confirmed when bone or joint can be felt with a sterile,
ophthalmological probe.

- Patients whose index diabetic foot ulcers are greater than 25cm2.

- Patients considered not in reasonable metabolic control, confirmed by an HgA1c greater
than 12% within previous 90 days,

- Patients whose serum creatinine levels are 3.0mg/dl or greater.

- Patients with a known history of poor compliance with medical treatments.

- Patients who have been previously randomized into this study, or are presently
participating in another clinical trial

- Patients who are currently receiving radiation therapy or chemotherapy.

- Patients with known or suspected local skin malignancy to the index diabetic ulcer.

- Patients on anticoagulant medication will as in any surgical procedure, be monitored
According to the protocols employed at the enrolling center.

- Patients diagnosed with autoimmune connective tissues diseases.

- Nonrevascularable surgical sites

- Active infection at site

- Sensitivity to the following antibiotics: Gentamicin, Cefoxilin, Linocmycin, Polymyxin
B, Vancomycin

- Any pathology that would limit the blood supply and compromise healing;

- Patients that have received a biomedical or topical growth factor for their wound
within the previous 30 days