Analysis of Lower Extremity Wounds Treated With Native, Cross-linked Extracellular Matrix and Broad-Spectrum Polyhexamethylene Biguanide: A Three-Year Retrospective Cohort Study

Background: Lower extremity wounds present unique management challenges to patients and clinicians alike.1 It is well documented that comorbidities such as peripheral vascular disease, immunocompromise and, in particular, diabetes can adversely affect healing.2 Wound biology factors are also of significance and effectively managing bioburden and wound chemistry is paramount for positive healing outcomes. One such technique to optimize wound healing biology is the use of skin substitutes such as native, cross-linked extracellular matrix and broad-spectrum polyhexamethylene biguanide*. 3 This three-year retrospective study examined wound healing in patients with lower extremity wounds treated with this specific skin substitute. Purpose: We present our findings of a three-year retrospective cohort review of patients with various lower extremity wounds treated with the skin substitute mentioned above.

Methods: A retrospective three-year review (2017 through 2019) of 50 patients with various lower extremity wounds was carried out for patients treated with the above-mentioned skin substitute in a hospital-based outpatient wound clinic. Various demographic and clinical data points were collected and examined. Wound size reduction during treatment was the main objective metric.  

Results: The study included 30 males and 20 females. Diabetic lower extremity wounds were the most common wound type followed by venous leg wounds. All wounds improved over time (p< 0.001). Between baseline and end of treatment the median decrease in wound area was 58.29%. Between baseline and one week post initial skin substitute application the median decrease in wound area was 69.62%. Between baseline and end of treatment the median decrease in wound volume was 63.87%. Between baseline and one week post initial skin substitute application the median decrease in wound volume was 78.31%.

Conclusion: A greater decrease in wound area and volume was seen after one week post initial skin substitute application compared to measurements at the end of the skin substitute application series. More research is necessary to explain this difference. *PuraPly AM™, Organogeneis, Inc., Canton, MA