mADM-assisted reconstruction may be useful for treating diabetes-related and traumatic foot wounds with bone defects after bone or joint resection, with its role appearing to lie in dead-space management, contour preservation and durable wound coverage, rather than bone replacement.
Complete epithelialization was achieved in 48 of 52 patients treated with mADM-assisted reconstruction of foot wounds with bone defects.
Four cases showed recurrence or delayed healing following mADM-assisted reconstruction.
Five patients developed mild early local infection after mADM-assisted reconstruction, all of which were successfully managed.
Radiological evaluation demonstrated generally preserved toe length and alignment following mADM-assisted reconstruction after bone or joint resection.
mADM was applied using multiple formulation types and procedural approaches in the study cohort.
The primary patient population consisted of diabetes-related foot wounds, with a smaller subset of traumatic wounds.
The authors concluded that the role of mADM in this context is dead-space management, contour preservation, and durable wound coverage rather than bone replacement.
This research suggests that a specialized wound treatment material called micronized acellular dermal matrix (mADM) — a processed tissue product with cells removed — can help heal complex foot wounds in diabetic and trauma patients who have had bone or joint removed. In a group of 52 patients followed for an average of nearly 15 months, about 92% achieved complete wound closure in an average of roughly 5 to 6 weeks. Minor complications like local infection occurred in a small number of patients but were all manageable with standard treatments, and no patients lost the graft material or developed spreading bone infection. The study also looked at X-rays in 40 patients to see whether the shape and alignment of the foot were maintained after the procedure. Results showed that toe length was preserved at about 91.6% of the original, and no patient developed significant angular deformity (greater than 10 degrees), suggesting the material helps maintain foot structure after bone removal. The mADM was used in different forms — as sheets, a paste, or a combination — and applied in either a single procedure or multiple stages depending on the wound. This research suggests that mADM's value in these challenging wounds lies primarily in filling the empty space left after bone removal, maintaining the contour of the foot, and providing a stable surface for new skin to grow — rather than replacing the bone itself. This distinction is important for clinicians choosing treatments for patients with diabetic foot complications or traumatic injuries that require bone resection, as it clarifies realistic expectations for what this material can and cannot do.
Nam H, Bae J, Kim S, Choi H. (2026). Long-Term Clinical and Radiologic Evaluation of Micronized Acellular Dermal Matrix-Assisted Reconstruction in Diabetes-Related and Traumatic Foot Wounds With Bone Defects.. International wound journal. https://doi.org/10.1111/iwj.70974