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Clinical Research

(CR-048) Establishing a Baseline for CTP Usage and Outcomes at a US Outpatient Wound Care Center

Thursday, May 16, 2024

7:30 PM – 8:30 PM East Coast USA Time

Amit Rao, MD

Introduction: Appropriate usage of cellular and tissue-based products (CTPs), or skin-substitutes, is necessary to protect the reimbursement of these advanced treatments. Cutting-edge technologies and techniques have a role to play in ensuring adequate wound bed preparation ahead of CTP application to increase their chance of successful integration, promoting more rational use. To understand their impact, we must first establish a baseline of CTP outcomes and usage patterns for comparison.

Methods: In this retrospective study, we gathered EMR data pertaining to all patients that received a CTP at Northwell Health outpatient wound clinic (New Hyde Park, NY) from Dec 2012 through Aug 2019. Patients were excluded if their baseline information was incomplete, if there were no follow-up visits after CTP application, or if they declined to participate in the study. We collected data from the day of the first CTP application and follow-up visits up to 12-weeks. We then analyzed the EMR data with respect to p</span>atient demographics, wound characteristics; number and type of CTP(s) applied, 12-week healing status, duration to healing, and recurrence rates up to 12-weeks.

Results: 88 patients were eligible for inclusion with wounds including VLU, DFU, PU, AU, and surgical. Most patients attended wound care visits on a weekly basis where they received standard care according to institutional protocols. A total of 170 CTPs were applied across these wounds within 12-weeks following the first application. The average number of CTPs applied per wound was 2 (range=1-6, SD=1). The most common CTPs applied were Apligraf, Epifix, Purapply, and Grafix. 5 patients were lost to follow-up at 12-weeks, and of the remaining patients 15 had their wounds heal by 12-weeks (15/83, 18.1%). For those 15 wounds, the average duration to healing was 6.1 weeks (SD=2.9, range=1-11). Only one of the patients healed by 12-weeks experienced recurrence during the study period.

Discussion:

These data indicate a relatively low CTP usage rate per patient. The 12-week healing rate is susceptible for improvement, however the low rate of wound recurrence within the study period is promising. Altogether these data provide a benchmark from which to compare CTP usage and outcomes after the introduction of advanced techniques and diagnostic wound care technologies such as bacterial fluorescence imaging.