{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:26:31Z","timestamp":1788233191750,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes, often requiring the use of advanced care products, which may have high upfront costs. With the hypothesis that this approach leads to faster healing, reduced costs, and better quality-adjusted life years (QALY), this study evaluates the economic outcomes, including cost-effectiveness and cost\u2013benefit, of an alloplastic polylactic acid (PLA) dermal matrix and compares it to collagen dressings in managing DFUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cost-utility analysis was based on a randomized controlled trial involving patients with DFUs treated with either PLA matrices or collagen dressings, alongside standard wound care. Data on wound healing, cost of care, and QALY were collected over the whole duration of the trial (31-week period). We conducted a cost\u2013benefit analysis by quantifying the monetary impact of reduced time-to-heal and avoided healthcare utilization. Additionally, we performed a cost-utility analysis using QALYs to capture patient-centered benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 12 weeks, 90% of the PLA group achieved wound closure compared to 30% in the collagen group, with PLA matrices reducing healing time by 44%. The cumulative cost of treatment for PLA was significantly lower, averaging $2,928 compared to $5,542 for collagen dressings (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Sensitivity analyses confirmed the cost-effectiveness of PLA even when home healthcare costs were excluded. Cost\u2013benefit analysis also demonstrated higher QALY in the PLA treated group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PLA dermal matrices provide a cost-effective alternative to collagen dressings, promoting faster wound closure, improved quality of life, and reduced healthcare costs. These results support the adoption of PLA as a preferred treatment for DFUs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1625252","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T11:54:27Z","timestamp":1760356467000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost-utility analysis of a polylactic acid matrix versus a collagen dressing for the closure of diabetic foot ulcers"],"prefix":"10.3389","volume":"13","author":[{"given":"Elaheh","family":"Khorasani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aashita","family":"Batra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Bartlett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bergquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brock A.","family":"Liden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Rangel-Berridi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1089\/wound.2019.0946","article-title":"Human wounds and its burden: an updated compendium of estimates","volume":"8","author":"Sen","year":"2019","journal-title":"Adv Wound Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.4239\/wjd.v13.i12.1106","article-title":"Diabetic foot ulcers: a devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities","volume":"13","author":"Akkus","year":"2022","journal-title":"World J Diabetes"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1001\/jama.2023.10578","article-title":"Diabetic foot ulcers: a review","volume":"330","author":"Armstrong","year":"2023","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e5383","DOI":"10.1097\/GOX.0000000000005383","article-title":"Ambulatory status before diabetic foot ulcer development as a predictor of amputation and 1-year outcomes: a retrospective analysis","volume":"11","author":"Clegg","year":"2023","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"101909","DOI":"10.1016\/j.foot.2022.101909","article-title":"Health economics of diabetic foot ulcer and recent trends to accelerate treatment","volume":"52","author":"Jodheea-Jutton","year":"2022","journal-title":"Foot"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1109\/MPULS.2020.3008460","article-title":"The future of wound care","volume":"11","author":"Bates","year":"2020","journal-title":"IEEE Pulse"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.25270\/wnds\/22094","article-title":"Final efficacy and cost analysis of a fish skin graft vs standard of care in the management of chronic diabetic foot ulcers: a prospective, multicenter, randomized controlled clinical trial","volume":"35","author":"Lantis","year":"2023","journal-title":"Wounds"},{"key":"ref8","first-page":"347","article-title":"A review of collagen and collagen-based wound dressings","volume":"20","author":"Brett","year":"2018","journal-title":"Wounds"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.12968\/jowc.2023.32.Sup4b.S1","article-title":"Best practice for wound repair and regeneration use of cellular, acellular and matrix-like products (CAMPs)","volume":"32","author":"Wu","year":"2023","journal-title":"J Wound Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e3266","DOI":"10.1002\/dmrr.3266","article-title":"Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)","volume":"36","author":"Schaper","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E257","DOI":"10.25270\/wnds\/23094","article-title":"Efficacy of a polylactic acid matrix for the closure of Wagner grade 1 and 2 diabetic foot ulcers: a single-center, prospective randomized trial","volume":"35","author":"Liden","year":"2023","journal-title":"Wounds"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"297","DOI":"10.25270\/wnds\/24060","article-title":"A multicenter retrospective study comparing a polylactic acid CAMP with intact fish skin graft or a collagen dressing in the management of diabetic foot ulcers and venous leg ulcers","volume":"36","author":"Liden","year":"2024","journal-title":"Wounds"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3390\/medicina57111190","article-title":"Oxygen, pH, lactate, and metabolism\u2014how old knowledge and new insights might be combined for new wound treatment","volume":"57","author":"Haller","year":"2021","journal-title":"Medicina"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"692","DOI":"10.12968\/jowc.2018.27.10.692","article-title":"The significance of collagen dressings in wound management: a review","volume":"27","author":"Pallaske","year":"2018","journal-title":"J Wound Care"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jval.2021.10.008","article-title":"Consolidated health economic evaluation reporting standards (CHEERS) 2022 explanation and elaboration: a report of the ISPOR CHEERS II good practices task force","volume":"25","author":"Husereau","year":"2022","journal-title":"Value Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/0168-8227(96)01198-9","article-title":"Psychological status of diabetic people with or without lower limb disability","volume":"32","author":"Carrington","year":"1996","journal-title":"Diabetes Res Clin Pract"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1097\/01.ASW.0000323589.27605.71","article-title":"An evidence-based model comparing the cost-effectiveness of platelet-rich plasma gel to alternative therapies for patients with nonhealing diabetic foot ulcers","volume":"21","author":"Dougherty","year":"2008","journal-title":"Adv Skin Wound Care"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1477-7525-1-80","article-title":"Problems and solutions in calculating quality-adjusted life years (QALYs)","volume":"1","author":"Prieto","year":"2003","journal-title":"Health Qual Life Outcomes"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/01.ASW.0000922704.17906.26","article-title":"The economic impact of living cell tissue products in treating diabetic foot ulcers and venous leg ulcers in patients with commercial insurance: a retrospective matched-cohort study","volume":"36","author":"Barbul","year":"2023","journal-title":"Adv Skin Wound Care"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/1472-6963-9-115","article-title":"Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers","volume":"9","author":"Langer","year":"2009","journal-title":"BMC Health Serv Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"S14","DOI":"10.12968\/jowc.2019.28.Sup9.S14","article-title":"Health economics for treatment of diabetic foot ulcers: a cost-effectiveness analysis of eight skin substitutes","volume":"28","author":"Samsell","year":"2019","journal-title":"J Wound Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"555678","DOI":"10.19080\/ARR.2020.06.555678","article-title":"A comparative analysis of the cost effectiveness of five advanced skin substitutes in the treatment of foot ulcers in patients with diabetes","volume":"6","author":"Snyder","year":"2020","journal-title":"Ann Rev Res"},{"key":"ref23","volume-title":"L39756 - skin substitute grafts\/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers","year":"2024"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1625252\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T11:54:38Z","timestamp":1760356478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1625252\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":23,"alternative-id":["10.3389\/fpubh.2025.1625252"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1625252","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,13]]},"article-number":"1625252"}}