Rapid Healing of a Chronic Trophic Ulcer in a Patient with Peripheral Vascular and Autoimmune Comorbidities using a Novel Self-assembling Peptide-based Advanced Dressing

The management of trophic ulcers poses significant difficulty due to their recurrent and recalcitrant nature. Furthermore, treatment algorithms are often complicated by associated systemic pathologies, which can bring devastating complications, such as amputations.[1]  While crucial to treat underlying diseases, it is equally important to ensure an effective local wound-management strategy to prevent complications stemming from a chronic ulcer.

A 59-year-old female patient presented with a non-healing trophic ulcer on the left lateral malleolus. The patient had a complex medical history with multiple systemic comorbidities, including lupus, scleroderma with Raynaud's phenomenon, small vessel peripheral vascular disease, and right below-the-knee amputation secondary to small vessel disease and a prior non-healing ulcer.

The current ulcer had persisted for four years despite the use of extensive standard and advanced wound care interventions, including debridement, moist wound healing, nitro paste, and skin substitutes. Management of the ulcer with a novel and proprietary self-assembling peptide-based product called, AC5 Advanced Wound System[2] (“AC5”), was initiated. AC5 was applied to the wound following excisional debridement, and the wound was covered with Xeroform and a dry secondary dressing. Subsequent applications of AC5 were performed weekly, for a total of three applications.

Treatment with just two applications of AC5 resulted in a dramatic healing of the ulcer, demonstrated by a greater than 90% reduction in wound volume. At the patient’s last visit on Day 19, the wound was completely epithelialized. Complete healing of this recalcitrant trophic ulcer, which was unresponsive to multiple wound management regimens during the prior four years, was achieved with only three applications of AC5 in less than three weeks.

The phenomenon was particularly impressive, considering the patient’s multiple vascular and autoimmune diseases, known to hinder the progression of wound healing and likely contributing to failure of prior wound-care regimens.