Tissue Selective Ultrasonic Debridement with Cryopreserved Human Skin Allograft to Heal a Chronic Wound: A Case Report

Purpose: This study highlights the use of tissue selective ultrasonic debridement* in combination of cryopreserved human skin allograft† to successfully heal a chronic wound. This method of operative debridement and application of graft has not been documented in literature.

Case Study: Patient is a 88 year old female with a history of HTN, hyperlipidemia, GERD, and chronic venous insufficiency that presents with an ulceration measured to be 6 x 3.0 x 0.2 cm located at the lateral distal left leg. The wound is just proximal too the lateral malleolus. The wound is 100% fibrotic with slough.

There is moderate amount oof serous drainage noted with no odor. The wound margin is irregular. The periwound skin is edematous, friable and moist. There is no tunneling, no sinus tract, and no undermining. Tissue selective ultrasonic debridement was selected for debridement of the fibrotic tissue. At the same operating room visit, cryopreserved human skin allograft was placed at the area of the ulceration and secured with sutures. Local wound care was then continued until full healing.

Analysis & Discussions: Ultrasonic debridement is an innovative method of debridement can be a tool that can be used to remove devitalized tissue selectively from the wound bed.

This technology can provide a therapeutic effect on the tissue in and around the wound bed as well as provide reduction and destruction of pathogens that occupy chronic wounds. The cryopreserved human skin allograft with both epidermis and dermis layer was chosen because it provides a supply of growth factors, cytokines and collagen to promote healing.

The combination of ultrasonic debridement with cryopreserved human skin allograft displayed full healing in our patient. We believe that this combination may provide satisfactory results in chronic venous wounds.