Closure of Stage IV Pressure Injuries with an Autologous Heterogeneous Skin Construct

Objective: Pressure injuries (PIs) are a difficult, costly and growing problem in the US and worldwide. Available treatments have high failure rates and, even when they are successful, wound recurrence is frequent. Pressure Injuries have significant negative effects on patient and caregiver quality of life and are a significant burden on the healthcare system. Surgical reconstruction under general anesthesia, though usually the quickest method of closure, is often not an option due to patient comorbidities and risk factors. An autologous heterogeneous skin construct (AHSC) made from a small, full-thickness ellipse of the patient’s own skin, has been shown to restore wound volume and close defects of varying types, sizes, and severity, without the need for general anesthesia.

This study analyzed the efficacy of AHSC to close complex stage 4 pressure injuries.

Methods: Retrospective chart examination of patients who received AHSC treatment for deep pressure injuries was performed. AHSC was evaluated for complete epithelial closure, function, reoperation rate, and complications Results: Patients from multiple institutions, with stage IV PIs of varying locations and etiologies were treated with AHSC. Several patients had failed one or more flap surgeries prior to AHSC treatment. Wound Healing Indicators (WHI) will be discussed. All wounds achieved significant volume restoration and coverage of exposed structures. There were no donor site complications.

Conclusion: AHSC can be used to restore wound volume, cover exposed structures and close recalcitrant stage 4 pressure injuries, with minimal donor site morbidity, and can be utilized as a minimally invasive alternative to reconstructive flap surgery. Additional prospective studies are needed to further evaluate the efficacy, safety, and durability of treating pressure injuries with AHSC.

Disclosures: Dr. Granick and Dr. Duncan receive consulting fees from PolarityTE. Drs. Blakely, Sopko, and Swanson are full-time employees of PolarityTE MD, Inc. No other author has any conflict of interest to disclose.