What to put on (and what to take off) a wound: treating a chronic neuropathic ulcer with an autologous homologous skin construct, offloading and common sense

Abstract

Closure of chronic lower extremity wounds is important for minimizing the risk of infection and amputation in a very high-risk population. Developments in tissue cultures and matrix therapies have shown promise in enhancing healing. The use of autologous homologous skin constructs in wound treatment may enable the regeneration of functional dermal structures. We present the case of a chronic medial heel ulcer that dehisced following intraoperative debridement, which was subsequently treated using a combination of an autologous homologous skin construct and total contact casting. This case emphasizes the importance of proper offloading for healing and preventing recurrence of lower extremity wounds.

A multicenter, randomized controlled clinical trial evaluating the effects of a novel autologous heterogeneous skin construct in the treatment of Wagner one diabetic foot ulcers: Final analysis

“…Multiple studies support the safety and efficacy of a novel autologous heterogeneous skin construct (AHSC) as adjunctive therapy used on complex and chronic wounds. [8][9][10][11][12][13][14][15][16][17][18] The AHSC is manufactured from a small autologous harvest of the patient's full-thickness, healthy skin, containing the skin's natural endogenous regenerative cellular populations that facilitate healing. [13][14][15][16][17]19 Within just a few days of harvest, the AHSC is processed by an external facility, returned to the provider and applied to wound in the outpatient setting.…”

“…Multiple studies support the safety and efficacy of a novel autologous heterogeneous skin construct (AHSC) as adjunctive therapy used on complex and chronic wounds 8–18 . The AHSC is manufactured from a small autologous harvest of the patient's full‐thickness, healthy skin, containing the skin's natural endogenous regenerative cellular populations that facilitate healing 13–17,19 .…”

A multicentre, randomised controlled clinical trial evaluating the effects of a novel autologous, heterogeneous skin construct in the treatment of Wagner one diabetic foot ulcers: Interim analysis

“…A novel autologous heterogeneous skin construct (AHSC) created from a small harvest of full thickness, healthy skin may be safe and effective as adjunctive therapy in treating complex and refractory wounds 15‐24 . AHSC is composed of small multicellular segments and contains the endogenous regenerative cellular populations of healthy skin that promote wound closure, so that a single application can regenerate full‐thickness, functionally polarised skin on the wound bed 20‐25 .…”

“…A novel autologous heterogeneous skin construct (AHSC) created from a small harvest of full thickness, healthy skin may be safe and effective as adjunctive therapy in treating complex and refractory wounds. [15][16][17][18][19][20][21][22][23][24] AHSC is composed of small multicellular segments and contains the endogenous regenerative cellular populations of healthy skin that promote wound closure, so that a single application can regenerate full-thickness, functionally polarised skin on the wound bed. [20][21][22][23][24][25] The manufacturing process of the AHSC retains the endogenous regenerative cellular populations associated with wound healing present within hair follicles, glands, and the interfollicular epidermis, facilitating engraftment optimisation and wound closure.…”

Autologous Heterogeneous Skin Construct Closes Traumatic Lower Extremity Wounds in Pediatric Patients: A Retrospective Case Series

“…1,5 An autologous heterogeneous skin construct (AHSC) has become available in recent years that has demonstrated the regeneration of full-thickness skin with follicles and glands. [6][7][8][9][10][11][12][13] AHSC utilizes a small, elliptical full-thickness skin harvest from the patient that can be closed primarily. The autologous donor skin is shipped to a biomedical manufacturing facility where it is manufactured into AHSC and can be returned for application to the wound bed as early as 48 hours after harvest and is viable for use for up to 14 days after harvest.…”