(CS-057) Continued Recalcitrant Wound Healing Using a Biocompatible Glass Fiber Matrix

Callie Horn, MD – Senior Surgical Resident, Surgery, Mount Sinai Hospitals; Lauren Rodio, BS – Clinical Research Assistant, Surgery, Mount Sinai Hospitals; John Lantis, MD – Site Chief and Professor of Surgery, Surgery, Mount Sinai Hospitals

Introduction:

In a case series previously performed at our institution, eight weekly applications of a novel, boron-based, biocompatible glass fiber-matrix (BGFM)* in patients with highly recalcitrant leg wounds of varying etiologies led to dramatic wound area reductions and three closures. The majority of these wounds had failed a minimum of three other biologics prior to BGFM* application. Considering the noted efficacy of BGFM*, we aimed to evaluate if continued BGFM* applications past our initial 8-week study period would result in continued wound area reductions and eventual closures or if some wounds would eventually fail to respond to BGFM*. 

Methods:

Eight wounds (2 DFUs and 6 VLUs) remained open after our initial eight-week study period. All patients continued to come to our vascular office on a weekly basis for debridement and irrigation, followed by the application of a thin layer of BGFM* and the placement of a nonadherent dressing. An offloading device or compression bandage was applied whenever appropriate. Weekly wound measurements, images, and wound characteristics were recorded for up to 26 weeks.

Results:

All wounds showed consistent wound area reductions and five wounds (3 VLUs and 2 DFUs) closed with weekly applications of BGFM*. DFUs continued to have a greater percentage wound area reduction compared to VLUs. DFUs required an average of four BGFM* applications for closure. The number of applications varied widely among the VLUs that closed, with one patient closing after 25 applications. All patients tolerated weekly BGFM applications well and had no adverse reactions or recurrences after closure.

Discussion:

BGFM* is highly effective at facilitating healing in recalcitrant VLUs and DFUs that have failed a minimum of three other biologics. With appropriate debridement and offloading, wound area reductions and closures can be achieved in both VLUs and DFUs using BGFM*, if the number of applications is not limited. Considering the degree of senescence in these wounds, a standardized number of product applications cannot be predetermined and the number of necessary BGFM* applications must be decided on a wound-by-wound basis. BGFM may promote more rapid healing of DFUs than VLUs, but a larger randomized study will be essential for a better understanding of the benefits and limitations of BGFM*.

A similar component was previously presented at Innovations in Wound Healing (IWH) 2023.