(CS-143) Complex Wound Approximation with Progressive Healing Mediator - Human Keratin Matrix

Kerry Thibodeaux, MD, FACS, CWSP. FACCWS, FAPWCA – The Wound Treatment Center & The Wound Treatment Center Consulting, LLC; Tracy Winkley, PT, CWS, CLT, FACCWS, DAPWCA – Beauregard Health System; Alexander Hernandez, OMS-IV – ULM VCOM; Carli David, OMS-IV – ULM VCOM

Introduction: Chronic wounds of the lower extremity arise as a complication from comorbidities such as diabetes mellitus and cardiovascular conditions which may increase morbidity and mortality rates in this patient population.  In this case series, we sought to understand how a human keratin matrix (HKM)*, an advanced wound care product, would affect the approximation of chronic/complex wounds in a rural wound care practice setting.  our goal was to apply an HKM* to bolster the approximation or rate at which a variety of complex wounds would close and track that progression over time.  Complex wounds targeted were diabetic and venous stasis ulcers that had been present for at least three months.

Methods: Four patients (2 female, 2 male, > 45 y/o) with a total of 5 chronic lower extremity wounds who were established patients at our wound treatment center were seen weekly for wound care including debridement, wound dimension measurements, and treatment with HKM* as well as appropriate secondary dressings as deemed necessary.  Our group of patients concurrently suffered from the following comorbidities:  hypertension, neuropathy, and Type 2 diabetes mellitus, and the oldest patient was a 61 y/o male.  Weekly follow-up and wound dimension measurements were taken and continued until complete wound closure.

Results: All five of the wounds achieved 50% wound closure within 8 weeks of treatment with HKM*.  HKM* was applied or resecured weekly.  At each weekly visit the HKM* was examined, and either a new HKM* was applied or the previous HKM* would be resecured with a collagen matrix dressing and multilayer compression wrap.  The five wounds demonstrated significant re-approximation, which included the largest (29.89 cm²) wound that approximated to (14 cm²) at 8 weeks of treatment.

Discussion: This case series investigated the application of HKM* to promote healing in chronic lower extremity wounds:  three diabetic ulcers and two venous stasis ulcers.  While HKM* was reapplied for the majority of the total wound care duration, at some of the follow-up appointments the HKM* that was placed the previous week was resecured with a collagen matrix dressing and multilayer compression wraps.  This supports previous data suggesting HKM* stimulates healing in chronic wounds, and demonstrates the capability that HKM* possesses to promote healing in cases where other advanced wound care product applications have struggled.