Placental-derived Allografts as Wound Care Adjuncts
Dr. Shawn Cazzell touches on the utility of placental-derived allografts and how proper wound debridement improves their efficacy.
Transcript
My name is Shawn Cazzell, a long-time surgical podiatrist. I've lived in the diabetic foot ulcer and venous leg ulcer market space for a vast majority of my career. Amputation prevention, surgical and outpatient wound care, and preventive at-risk foot strategies have always been a passion of mine, and so I feel very fortunate to be in a position to participate at the level that I have been over the course of the last 10 or 15 years. I have a rather large surgical and wound practice. I dedicate about 60 to 80% of my time currently, running randomized controlled trials for corporations across the globe, looking at reducing the number of days a wound remains open, knowing that each and every day a wound is open is another day that a wound could become infected.
That's a great question. So we already touched upon the four phases of wound healing. And what we do know is that placentally-derived allografts are an opportunity when the wound bed can act as an adequate recipient to improve wound healing trajectories, decrease days to closure, and move through those four phases of wound healing as quickly as possible. Specific to your placentally-derived allografts, what are they? They're immunologically privileged with the presence of extracellular matrix proteins, cytokines, inflammatory modulators, cell signaling molecules, just to name a few. So I tell my patients, I tell people when I'm on the podium, these act as accelerants, but only in the setting of a quality wound bed that has the ability to break out and move forward through the phases of wound healing so that we can achieve a closure and subsequent two-week confirmation of closure visits and/or being stamped healed at that point in time.
Absolutely. So I think increased frequency of debridement--specifically on a weekly basis, which was demonstrated in the paper to be clinically more effective essentially than biweekly or greater--provides the most viable wound bed, acting once again as that adequate recipient for allografts in general. Whether we're talking about placentally-derived allografts or a human acellular dermal matrix, given the characteristics and the needs of the wound, I should say, given the characteristics of the wound bed and/or just the overall needs of the wound. Some of our large, deep cavitary wounds that have been created as post-surgical defects in a limb salvage scenario might require the utilization of negative pressure wound therapy and something like human dermis versus a placentally-derived allograft.
A lot of that is just going to be built into the practitioner's algorithm and how they carry forward their care guidelines. But I think placentally-derived allografts have a decent tensile strength, they have ease of application. For the most part, they can be stored at ambient, at room temperature, and they have a very long shelf life. So I think ease of use is important, but at the end of the day, I think all of us need to be thinking about how we can increase value to our patient population and help continue to move forward this entire wound care arena.
