Integra Dermal Regeneration Template (IDRT) is a dual-layer, acellular dermal substitute made of type I collagen and chondroitin-6-sulfate. It also has a temporarily epidermal substitute layer made of a thin polysiloxane (silicone) layer to control moisture loss from the wound. The successful use of IDRT in different wound reconstruction has been widely reported, however, such reports are very limited in the diabetic foot. Here we present the first Kuwaiti study for diabetic foot reconstruction using IDRT. Our tech-nique entails use of Vacuum Assisted Closure (VAC) to normalize the time needed for engraftment. Results showed very high engraftment rate and patient satisfaction with no serious complication, ulcer recurrence, or amputation for 3-years follow up.