(CS-046) The Use of a Self-Assembling Peptide Wound Care Matrix in a Limb Salvage Setting

Spider and insect bites can lead to local skin necrosis and infection, occasionally leading to limb and/or life-threatening status. Even with aggressive surgical and local wound care, these wounds present a challenge to clinicians due to the significant local tissue damage and limited soft tissue coverage over osseous structures. This case report presents the use of a novel and innovative synthetic  self-assembling peptide wound matrix (aSABS*) in the treatment of a hard to heal wound.

Methods: A 52 year-old male with a history of diabetes and hypertension presented to the clinic with a history of a documented spider bite to his left ankle, leaving a painful, necrotic eschar and leading to necrotizing fasciitis. Incision and drainage with surgical debridement was performed in the OR. This left a large, painful defect in the lateral malleolar area with chronic inflammation. After several months and attempts to heal the open defect using bio-engineered skin substitutes, the wound failed to granulate and amputation was offered. The use of a novel self-assembling peptide wound care matrix was initiated as a last resort to amputation and positive results were noted.

Results:

Within 6 weeks, the wound progressed towards healing with abundant granulation tissue and function to the ankle restored with 4 applications of aSABS. Pain 

scale levels dropped from 9/10 to 2/10 after one application. The patient was able to return to work and other activities. No additional surgeries were necessary.

Discussion:

The novel aSABS is made of a proprietary synthetic peptide with natural occurring amino acids. When exposed to ions in the wound, peptide matrix self assembles into a nano fiber network mimicking an extracellular matrix scaffold to facilitate tissue growth and repair. The matrix also provides a physical barrier to help mitigate contamination and modulate inflammation.^1-2 The product is easy to apply with the ability to contour to any irregular wound geometry. This case report shows the rapid onset of wound granulation as well as a considerable decrease in pain allowing the patient to return to work and negating the need for amputation. This initial experience with the use of the self assembling peptide matrix shows its use as  a viable wound management solution in the treatment of hard to heal wounds and as such further studies are recommended to determine its applicability in other chronic wound situations.

* aSABS - adaptive self assembling peptide barrier scaffold

 

Trademarked Items:

References: 1. Kapp D, Pfendler L, D'Oro L, Wolcott R. Early clinical performance of an adaptive self-assembling barrier scaffold in nonhealing chronic wounds: a review of six cases. Wounds. 2022 Jan;33(1):20-30. doi: 10.25270/wnds/2022.2030. PMID: 35108216.

2.Ellis-Behnke R, Liang SWH, Jonas RA, et al. Anti-inflammatory effect of a self-assembling peptide (AC5TM) in the lipopolysaccharide induced inflammation model of eye injury. Poster presented at: Military Health System Research Symposium (MHSRS); August 20–23, 2018; Kissimmee, Florida.