Mayo Clinic AZ Lived Experience: Exploring the Use of Biologic Products for Difficult-to-Heal Wounds

Purpose/Significance: Utilization of modalities such as enzymatic collagenase ointment, hydro fiber silver, methylene gentian violet, silicone dressing, medicated honey, and collagen are appropriate choices for wound care; however, there are cases when prolonged use of such is not appropriate for stalled wound. The purpose of the study is to determine whether use of biologic product in chronic wound decreases wound dimension and shortens healing time. Patient and staff satisfaction were also explored.

Methods: Team decided to explore use of amniotic membrane allograft (AMA) and allogenic decellularized particulate human tissue (ADPHT)—biologic products derived from human placenta. Five patients with wounds that had not reduced in size within 30 days of utilizing standard of care were included in the study. Wound etiology varies for the five patients chosen. Provider offered the biologic dressing to the patient; serial photograph and wound measurement taken for every visit. Patient’s experience in the use of the product was also documented by staff. Study was terminated once patient’s wound had healed and if no significant change was noted to the wound after four weeks. Staff satisfaction in the use of the biologic was gathered at the end of four-week trial.

Result: Two patients were dropped due to nonadherence and onset of infection not related to the biologic dressing. Surgical wound size decreased, resulting in 60% healing in 3–4 weeks. Improvement was observed for mixed lower extremity disease wound at 25% healing in two weeks. Staff also noted that biologic dressing may not be a good alternative for dermatologic lesion. Both patients and staff reiterated overall high satisfaction with ease of application, comfort, and effectiveness. Staff recommended that frequency of dressing change should be more than once per week for highly exudating wounds.

Conclusion: Biologic dressing should be considered in managing chronic wounds.