Flowable Biomimetic Matrix Moves Chronic Venous Leg Ulcer from Failed Skin Substitute Therapy to Complete Closure: A Case Report

Introduction: Venous leg ulcers (VLUs) present a significant clinical challenge due to their delayed healing and high recurrence rates with only 60% closing by 12 weeks, and 75% reappearing within 3 weeks1.  Comorbidities such as diabetes, lymphedema, psoriasis, and other skin conditions further exacerbate these challenges. This case report describes the use of a novel biomimetic matrix (BMM) in managing a chronic VLU that had not improved after repeated skin substitute therapy in a patient with multiple risk factors for impaired healing and wound recurrence. BMM is a flowable antibacterial polypeptide technology designed to prevent infection and support tissue regrowth, while conforming to irregular, deep, and hard-to-access wounds.  Methods:The patient was a 78-year-old female with a medical history of diabetes, venous disease, lymphedema, hemosiderosis, psoriasis, skin fibrosis, and previous skin cancer. She developed a VLU in the right anterior leg, mid-tibia, post-excision of a large squamous cell carcinoma. Despite appropriate standard of care and repeated applications of a fish-derived skin substitute, the ulcer remained chronic.  After 10 weeks of failed treatment with fish skin grafts, the patient was switched to BMM, applied topically per manufacturer instructions, alongside continued standard of care including multilayer compression.  Wound measurements were recorded at baseline and during each visit.  Wound healing progression, peri-wound skin condition, and adverse events were monitored throughout the study.Results:Despite previous failure of fish-derived skin substitutes over 10 weeks of treatment, rapid improvement in VLU healing was observed following BMM application. Significant reductions in wound size and depth were noted after a single BMM application. Remarkably, complete wound closure was achieved with five BMM applications, and no recurrence was observed during the follow-up period. Moreover, peri-wound skin appearance improved substantially. No product-related adverse events were reported.Discussion: BMM successfully facilitated healing of a chronic, non-responsive VLU in a patient with several comorbidities, achieving complete wound closure with just five applications. These findings highlight BMM’s potential for rapid healing progression in chronic wounds unresponsive to traditional skin substitutes and advanced wound care products, which could signify a change in clinical practice. Further studies are necessary to confirm these results and determine BMM’s efficacy in a larger patient population.References:1Probst S, Weller CD, Bobbink P, et al. Prevalence and incidence of venous leg ulcers—a protocol for a systematic review. Systematic Reviews. 2021;10(1):148.