Healing of a Chronic Refractory Burn Wound with a Novel Self-assembling Peptide-based Advanced Wound Dressing

Burns wounds are chronic conditions that require extended surveillance and follow-up beyond the acute hospitalization phase. Management of patients with chronic burn wounds requires a multi-pronged approach due to a complex pathophysiology stemming from the risk of persistent inflammation, infection, prolonged remodeling, and improper scarring.

A 49-year-old patient presented with a chronic open wound due to breakdown of severe scarring, which had resulted from an extensive burn across his chest and flank that occurred over two decades ago. Major challenges with the wound included its extreme friability and its presence in areas prone to continued friction with clothing, which in turn led to frequent and extensive bleeding that was further compounded by a strong fungal and bacterial burden in the wound bed. The wound had persisted despite multiple interventions over the years.

As a component of our biofilm focused wound care protocol, the patient was treated with aggressive debridement along with the application of a novel and proprietary self-assembling peptide-based advanced wound dressing.[1] This novel dressing formed a clear gel network on the wound, thus allowing observation of the wound over the course of the procedure while maintaining tissue sealing due to its ability to contiguously conform to the wound bed. Two weeks post initial treatment, the wound bed surface was treated with a second application of the peptide along with debridement. It was noted to be less friable and demonstrated less bleeding than before. Our subsequent observations indicate that after two interventions, the wound bed quality improved with a healthier tissue appearance, evident granulation buds, and the wound surface exhibiting less slough and exudate. More importantly, the patient noted cessation of intermittent bleeding episodes, alleviating the burden of at-home wound care.

In conclusion, use of this novel self-assembling peptide-based advanced wound dressing not only accelerated the healing of a severe refractory burn wound, but it also provided marked improvement in quality-of-life for the patient, thus presenting a viable approach to optimize functional recovery in this setting.
 

Trademarked Items (if applicable): [1] AC5®Advanced Wound System, Arch Therapeutics, Inc., Framingham, MA