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Evidence to Improve Care

Skin Substitutes for Adults With Diabetic Foot Ulcers and Venous Leg Ulcers

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding skin substitutes for adults with difficult-to-heal neuropathic diabetic foot ulcers

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends against publicly funding skin substitutes for adults with difficult-to-heal venous leg ulcers

Read the final recommendation report


Wounds such as diabetic foot ulcers and venous leg ulcers can be difficult to heal. Diabetic foot ulcers are a common complication of diabetes. They form because of pressure or repetitive irritation to the skin tissue on the foot, which then breaks down, exposing the layers underneath. Venous leg ulcers are sores on the leg that are very slow to heal. They are usually caused by poor blood flow in the leg.

Diabetic foot ulcers and venous leg ulcers are usually treated with dressings such as absorbent dressings and antiseptic dressings. Skin substitutes are a new treatment. They cover open skin wounds and can be helpful when dressings do not work well enough. Skin substitutes work by acting like normal skin.

This health technology assessment looked at how safe, effective, and cost-effective skin substitutes are for adults with diabetic foot ulcers or venous leg ulcers. It also looked at the budget impact of publicly funding skin substitutes. And it looked at the experiences, preferences, and values of people with diabetic foot ulcers and venous leg ulcers.

Read the full health technology assessment report for more information.

Skin Substitutes for Adults With Diabetic Foot Ulcers and Venous Leg Ulcers: A Health Technology Assessment (PDF)
June 2021

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.




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