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A Randomized Controlled Trial to Evaluate the Treatment of Venous Leg Ulcers with a Novel Autologous Heterogeneous Skin Construct
Introduction and Objective: A novel autologous heterogeneous skin construct (AHSC) has been developed for the repair and replacement of skin. A pilot study demonstrated the ability of AHSC to close venous leg ulcers (VLUs).1-3 A subsequent randomized controlled trial (RCT) (NCT03881267) was designed to investigate whether AHSC is a viable treatment for VLUs. The objective of this study is to present the topline data from the RCT comparing standard of care (SOC) plus AHSC to SOC alone.
Methods: 30 patients with VLUs involving skin and subcutaneous tissues not involving bone, tendon, or capsule ranging in size from 1-20cm2 that failed at least 4 weeks of prior treatment were enrolled. Following consent to participate in the trial, patients underwent a 2-week run-in period of SOC treatment defined as a collagen-based primary layer covered with supportive dressings and high compression therapy. Patients with ulcers that did not change in size by greater than 30% during the run-in period were randomized 1:1 to treatment with a single application of AHSC or continued SOC. Wounds were assessed by visual inspection, planimetry and blinded high-resolution digital photography. Following determination of closure by the treating investigator, a blinded-panel of adjudicators confirmed wound closure.
Results: The primary endpoint was the percentage of ulcers healed at 12 weeks. Secondary endpoints were percent area reduction (PAR) at 4, 6, 8, and 12 weeks; improvement in quality of life using wound quality of life score and change in pain levels. Graft take at each visit was assessed. Results from analysis of 30 enrolled subjects will be presented.
Conclusions: This trial is designed to evaluate whether AHSC is a viable treatment for VLUs. Disclosures: The Professional Education and Research Institute, whose Medical Director is Charles Zelen DPM, FACFAS, received research support from PolarityTE to administer the randomized controlled trial. PolarityTE assisted in assembling this abstract.
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References
References: Zelen and Armstrong DG. “45-LB: Results of a Pilot Evaluation of a Novel Autologous Homologous Skin Construct Treatment of Diabetic Foot Wounds Refractory to Conventional Treatments”. Diabetes 2019 Jun; 68(Supplement 1). doi.org/10.2337/db19-45-LB Armstrong DA, Orgill D, Galiano R, Glat P, Zelen C. “Closure of Refractory Diabetic Foot Ulcers and Venous Stasis Leg Ulcers Using a Single Application of an Autologous Homologous Skin Construct in the Clinic Setting”. Symposium on Advanced Wound Care (SAWC) Spring 2019 (San Antonio, TX). Presented on May 9th-10th, 2019. Armstrong D., Orgill D., Galiano R., Glat P., Zelen C. “Late Breaking: Results of a Pilot Evaluation of a Novel Autologous Homologous Skin Construct Treatment of Diabetic Foot Wounds Refractory to Conventional Treatments”. ePlasty Presented at the American Diabetes Association (ADA) 79th Scientific Sessions (San Francisco). June 9th, 2019.
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Autologous Heterogeneous Skin Construct (AHSC)