The Use of Borate-Based Bioactive Glass Fibers and Particulate in the Healing of Multiple Wounds
Background: Bioactive glass (BG) is useful as bone replacement material and for soft tissue engineering. Bioactive properties of BG include hemostasis, antimicrobial effect, epithelial cell migration, angiogenesis, and fibroblast cell proliferation, which are useful attributes with all phases of wound healing. There are increasing reports of BG usefulness in general wound healing.
Objective: We reviewed our initial experience using a borate based BG product (BBG).
Methods: Wound care techniques included cleansing, debridement of necrotic/devitalized tissue, then application (2-3 mm thickness) of BBG to cover wound before covering with absorbent dressing or gauze. Dressings were changed every 2-7 days depending on exudate and patient logistics. Tracts and undermined areas were filled with BBG. Revascularization was performed in 2 patients with CLI. VSU and lymphedema patients were treated with MLCD. DFU patients were offloaded. Our initial experience of 30 patients with 41 wounds (ages 28-98 years, mean 67.2) treated with BBG is reported.
Results: 20 wounds in 15 patients healed completely. The average wound size was 8.26 (1-34.65) cm2 with average number of BBG applications 8.2 (1-25). The average length of healing time was 9.1 (2-20) weeks. 2 patients (5 wounds) died during therapy--one with 40% SAR of DFUs (week 5) from PE and the other (98 years old hospice patient) after 2 weeks. 3 patients had early (<3 week) therapy change--2 required great toe amputation for osteomyelitis and another after skin cancer diagnosis. One patient with 3 wounds changed provider to be closer to home on week 10 (49% SAR). 9 patients with 10 wounds are still receiving treatment. 3 patients had chronic (6-24 months) wounds but have now achieved 80% SAR after 20-26 week therapy (average wound 21.4 cm2). One patient (with indwelling infected spinal hardware) has 57.2% wound size reduction after 20 weeks. 5 patients with 6 wounds have been treated 2-7 weeks with 34% (29-93) SAR (wound sizes 1-178 cm2).
Conclusion: Initial evaluation of BBG demonstrates significant successful wound healing for a wide variety of wounds. Further study is needed but results are promising.
