Case Series/Study

(CS-062) Management of Deep Tunneling Wounds with Novel Allograft Adipose Matrix: A Natural Off-The-Shelf Treatment Modality

Co-Author(s):

Robert Galiano, MD FACS

Introduction: Chronic non-healing wounds present a substantial economic burden with a reduction in patient quality of life, and often result in limp amputations or premature deaths. This burden increases with elderly patients and increasing prevalence of life-style diseases such as obesity and diabetes.
<span lang="EN" style="font-size: 12.0pt; line-height: 150%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin;"> 
<span lang="EN" style="font-size: 12.0pt; line-height: 150%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin;">There is a lack of clinical options for the treatment of deep tunneling chronic wounds, when first line treatment fails. This study evaluates the efficacy of Allograft Adipose Matrix (AAM), an aseptically processed “off-the-shelf”, ready to use allograft, to treat tunnels and cavitation within chronic wounds by providing a scaffold and cushion to support the wound bed. Methods: <span lang="EN" style="font-size: 12.0pt; line-height: 150%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin;">This case series examined patients with deep tunneling and cavitation chronic wounds. AAM was injected subcutaneously to fill the tunnels and soft tissue deficits within the wound bed. Patients were evaluated for possible complications related to wound healing and infection. Results: <span lang="EN" style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-ansi-language: EN; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">The <span lang="EN" style="font-size: 12.0pt; line-height: 115%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-ansi-language: EN; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">eleven patients (seven males; four females) that were treated had an average age of 65 years (ranging from 35-78 years). Of the 11 wounds in this case series, the etiologies were post-surgical (n=7), traumatic (n=2), and foot ulcer (n=2). Ten patients had only one application of the AAM, and one patient had two treatments. The volume of AAM applied was 2cc to fill the adipose tissue deficit and the average follow-up after AAM application was 6.6 weeks. Observations indicated that tunneling and cavitation in the wound subsided. Seven patients (63%) went on to achieve complete wound closure. Discussion: <span lang="EN" style="font-size: 12.0pt; line-height: 150%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin;">AAM is a novel use of an off-the-shelf allograft tissue, targeted towards a very frequently occurring pathology. AAM does not present the challenges associated with autologous fat grafting. The use of AAM provided a physical cushion and scaffold for deep tunneling and cavitation within these chronic wounds. This increased padding with the wound bed ultimately support wound closure. Trademarked Items: References: