Application of Cryopreserved Human Split-Thickness Skin Allograft* for Pain and Wound Size Reduction in a Sensate Non-diabetic Female

Introduction: 62 year old female who presented to the emergency department with a left leg ulceration measuring 3.0 x 2.8 x 0.6 cm which had been present for 2.5 months. Significant pain was present on exam and subsequent exams even after improvement in wound size after applications of decellularized fish skin graft☐ and collagen bilayer wound matrix°. Pain was uncontrolled with opioid prescriptions and patient had not noticed improvement to pain level after applications of decellularized fish skin graft☐ and collagen bilayer wound matrix° over a two month period. She then underwent application of graft with the proximal aspect of the wound receiving collagen bilayer wound matrix° and the distal aspect of the wound cryopreserved human split thickness allograft*. One week postoperatively, she experienced a notable reduction in pain to the distal aspect of the wound which received a human split thickness allograft*. She later had this same product applied to the entire wound noting continued pain reduction. Pain steadily decreased reaching a 1/10 independent of wound size.Methods:Patient was treated while hospitalized and in an outpatient clinic by a single fellowship trained foot and ankle surgeon from September 2022 until the publication of this study. Wound was measured at each appointment and VAS was used to measure pain level at each appointment.Results:There is an apparent decrease in pain associated with application of cryopreserved human split thickness skin allograft* independent of wound size. Though patient had difficulty with wound healing and delays, her quality of life improved and she was able to return to normal activities due to significant decrease in pain. At the submission of this abstract, patient experienced a 90.5% reduction in wound size and reported VAS at 0.Discussion: Cryopreserved human split-thickness skin allograft* may result in reduction of pain versus application of collagen bilayer grafts° and  decellularized fish skin graft☐ while also resulting in a 90.5% reduction in wound size in a 20 month period. Though promoting wound healing was the initial goal of application, patient reported a significant improvement in pain with VAS scores after receiving cryopreserved human split-thickness skin allograft*. The purpose of this case presentation is to demonstrate the apparent association of pain reduction with application of cryopreserved human split-thickness skin allograft* though additional research is needed in a larger patient population.References: