Management of a Chronic Radiation Necrosis Wound with Lyopreserved Placental Membrane Containing Viable Cells

Background: Cryopreserved placental membrane containing viable cells (vCPM) has shown clinical effectiveness in several studies in the treatment of acute and chronic wounds including nonsurgical management of a large necrotic nasal tip wound. Recently, the lyopreserved formulation of placental membrane has been developed using a novel lyophilization technique that allows storage of viable tissues at ambient temperatures.

Purpose: Here the authors describe the use of a lyopreserved placental membrane containing viable cells (vLPM) for the conservative management of a chronic refractory radiation necrosis wound in a patient with multiple co-morbidities. 

Methods: A 73-year old female with a history of Rheumatoid Arthritis, systemic sclerosis, lymphedema, mild chronic venous insufficiency, and squamous cell carcinoma presented with a radiation necrosis wound on the right medial ankle. The 1.57 cm2 wound duration was 1 year and had been previously treated with various collagen dressings, honey-impregnated dressings, topical antibiotics, and multiple rounds of oral antibiotics. Due to extensive inflammation and fibrosis of the wound, this patient was not a candidate for surgical closure, and was selected to receive weekly applications of vLPM.

Results: The patient achieved complete wound closure after 12 applications of vLPM in 98 days, and the wound has remained closed 3 months after initial closure. The patient experienced no adverse events related to vLPM. 

Conclusion: In the current study, we evaluated vLPM in the treatment of a chronic refractory radiation necrosis wound in a patient with multiple co-morbidities who was not a candidate for a surgical wound management. The positive outcomes of the clinical case presented here suggest that vLPM provides a good conservative option in the treatment of chronic refractory radiation wounds in patients with impaired wound healing.