(CS-024) Complex Refractory Wounds: Innovative Bioactive Glass Wound Matrix Facilitates Healing in Setting of Radiation, Steroid Use, and Multiple Failed Prior Treatments

Phuong Thuy Nguyen, MD

Introduction: Chronic wounds are detrimental to patient quality of life and a significant strain on the healthcare economy. To reduce healthcare utilization, use of advanced wound care products that address essential components of the healing phases of chronic wounds is critical. A recently developed novel borate-based bioactive glass wound matrix* (BGWM) has been shown to promote healing in complex chronic wounds. Borate-based bioactive glasses are biocompatible water-soluble materials that have been formulated to degrade in a wound over a period of days or weeks. These absorbable bioactive glasses have shown promise in wound healing by improving angiogenesis, increasing metabolic activity and cell proliferation, and reducing incidence of infection. We report our experience with application of BGWM in recalcitrant, non-healing wounds previously treated with multiple advanced wound care modalities.

Methods: Three patients with three wounds were treated. Wounds were cleansed with sterile normal saline solution and debrided. Systemic antibiotics were administered as needed. BGWM was shaped to fit the size of the wound bed and pressed directly in contact with the wound, covering the entire wound area and overlapping 3-4 mm onto periwound. A cover dressing was applied over BGWM to secure the matrix and absorb exudate. Dressings were changed once per week.

Results: The mean age of patients was 72 (range: 56-84). Two surgical wounds and one radiation wound were treated. All three wounds in this series had failed multiple previous advanced, costly therapies and surgeries with a mean wound duration of 13.2 months. Mean wound size volume at start of BGWM was 1.9 cm³. All wounds healed after a mean of 8.1 weeks with use of BGWM.

Discussion: In these three patients, BGWM was employed as a solution after many other modalities failed, and the results were excellent. All previously recalcitrant, non-healing wounds were healed following BGWM initiation, and the matrix was used until complete closure. Application was simple and well-tolerated by patients. Storage of BGWM was easy due to its long shelf life. No pain or discomfort was reported upon application, and patients expressed high satisfaction with the speed of the procedure. Patients reported a reduction in wound pain after the second BGWM application. Compared to other skin substitute matrices previously used, less time was required for wound bed preparation with BGWM. However, BGWM has unique properties, and product training is recommended prior to use, particularly because the product can change in color based on wound exudate.