Pressure Ulcers Treated with a Novel Autologous Homologous Skin Construct in a Retrospective Multi-center Case Series

Introduction: The fastest growing segment of the population is those over 65yo while national rates of obesity, diabetes, and cardiovascular disease are rising – leading to more patients having decreased mobility.1,2 Immobility can lead to pressure sores or sacral ulcers. Pressure ulcer treatment is extensive and is a growing financial burden on the healthcare system. In the US, roughly $11B dollars is spent on the treatment of pressure ulcers annually, with some pressure ulcers requiring up to $70,000 to close.3 An autologous homologous skin construct (AHSC) using the patient’s own living progenitor cells with intact differentiation pathways has demonstrated to regenerate full-thickness skin in-vivo, to close wounds of varying etiologies.4-6 Methods: A retrospective, multicenter analysis of patients who received AHSC treatment for pressure ulcers of multiple etiologies was conducted over the last year. Small areas of full-thickness skin were harvested, processed into AHSC and applied on prepared wound beds. AHSC was evaluated for its ease of use, donor site morbidity, and ability to close pressure sores with full-thickness skin. Patients attended routine follow-up appointments during which time the silicone cover dressing was exchanged, and wound closure progression was recorded. Results: 12 patients with pressure ulcers were treated with AHSC at six different medical institutions across the United States. Patient age range was 13-70yo. Immobility etiologies include cerebral palsy, spastic quadriplegia, severe scoliosis, paraplegia, and extended hospitalization. Mean wound surface area at time of AHSC application was 42 cm2 (range: 9cm2—90cm2). Mean donor harvest size was 3.9cm2. All donor sites healed without adversity. All wounds experienced graft take and progressive epithelialization was observed in the first few weeks post-AHSC application. There were no complications utilizing the AHSC workflow in both OR and clinic settings, and no further procedures were required during follow-up. Wound closure progression and therapeutic durability was assessed at a range of 5—15 months. Conclusion: The biomedical burden of pressure ulcers is enormous and healthcare expenditures on this indication are only rising. Pressure ulcers may be successfully treated with AHSC. Additional prospective studies are needed to further evaluate the functional outcomes of pressure ulcers treated with new modality.