"Improvement in Pain Scale Utilizing a Bioengineered Skin Substitute in Lower Extremity Wounds: A Retrospective Review"

Background: Bioengineered skin substitutes have become a viable option in wound care. There are several wound care products available for physicians to utilize depending on the type and stage of the wound. Questions often arise as to what product should be used at a specific phase in the wound healing process. There is literature available explaining the science, efficacy and cost behind a given product. What is lacking, however, is how the wound care product will affect patient comfort. While some patients with lower extremity wounds are insensate, there are many individuals who do report significant pain to their wounds

Purpose and Methods: A retrospective review was performed over a five-year period evaluating a subjective improvement in pain scale recorded by patients who underwent the procedure “skin substitute graft application of the trunk/arm/leg”. One hundred thirty five surgical cases were performed on patients that included one or multiple wound sites, sensate limbs, pressure and venous stasis wounds. Exclusions included wounds recorded to be above the level of the tibial tuberosity, infection, or those without adequate vascular supply to support grafting.

Results: Five different types of skin substitutes were utilized and examined. The biologically active, cryopreserved real human skin allograft, proved to show the most improvement in pain specifically dealing with venous stasis ulcerations. This result was determined using the standard medical pain scale (1-10), showing a greater decrease in pain experienced by the patient post graft application.

Conclusion: To our knowledge, no other study has evaluated the improvement of pain in patients after application of skin substitute. This study reveals a statistically significant improvement in pain scale using a specific skin substitute compared to other biologics on the market. The authors believe this study will further aid wound care physicians’ decision on advanced therapy options for those patients with painful chronic wounds.