Management of Fournier's gangrene non-healing wounds by autologous skin micrograft biotechnology: a new technique

Abstract

Fournier's gangrene is an acute bacterial infection producing necrosis of the perineum and external genitalia that generally affects elderly men. Although skin grafts and flaps are the standard procedure for reconstruction, sometimes wounds can become chronic. Rigenera Protocol is a new technique based on autologous skin micrografts that reactivates and supports wound healing. A 40-year-old male with Fournier's gangrene, due to a rectal microperforation following diarrhoea, was treated with surgical debridement, negative pressure wound therapy and subsequently coverage with skin grafts. He developed non-healing wounds treated by Rigenera protocol after two months of advanced wound dressings. This technique is based on skin micrografts obtained by mechanical dermal disgregation to provide mesenchymal stem cells and extracellular matrix to the wound. The suspension injected into the wound triggers reactivation of healing without significant residual scarring on both donor site and treated area. Non-healing wounds were reduced by 15% at day 7 and by 50% after 30 days. Wounds completely healed after seventy days. The regenerated tissue appeared closer to skin graft than to scar tissue. This report shows how the use of skin micrografts through Rigenera protocol can be a useful method to reactivate wound healing resulting from Fournier's gangrene, with no discomfort for patient in a practical, safe and easy way.

Acceleration of Skin Wound-Healing Reactions by Autologous Micrograft Tissue Suspension

“…To date, although many clinical studies of the MG technique (Rigenera protocol) have been used to make wound-healing time more effective, research has been limited to case reports [ 14 , 15 , 16 , 17 , 18 , 24 ]. In most reports, the technique has been adopted as an ultimate treatment.…”

Progress report for intractable ulcer and osteomyelitis cases using autologous micrografts

“…Previous studies have described the clinical effectiveness of this protocol in the management of chronic wounds, such as dehiscences and ulcers, 6–9,12–14 and the results reported for Case 1 are in line with other authors who have already reported the role of micrografts in the reactivation of wound healing resulting from Fournier’s gangrene. 10…”

Tissue regeneration: an overview from stem cells to micrografts

“…61 Micrografts have also been used for other non-healing wounds, such as those developing following Fournier's gangrene or chronic osteomyelitis, showing a reduction in wounds after approximately 1 month of treatment. 62,63 The efficacy of micrografts has also been reported in repairing cartilage defects, for cartilage regeneration in patients affected by external nasal valve collapse, 64 and the treatment of function-limiting and painful knee chondral injuries. 65 An in vitro study showed that autologous micrografts influenced chondrocyte differentiation, increasing deposition glycosaminoglycans and the presence of collagen II in primary human cells cultured in the presence of micrografts, which supported the formation of chondrogenic micro-masses and acted as a scaffold for chondrocytes.…”