Case Series/Study
The patient noted significant improvement in her pain following surgical debridement and application of OFM particulate and graft which allowed her to minimize and ultimately discontinue her chronic use of narcotic pain medication due to the long-standing scleroderma skin ulcer. There was a noted improvement in the wound bed quality and noted development of functional and viable neodermis noted at 4 weeks after surgical application of OFM particulate and graft. Patient elected to allow for further OFM treatment to further reduce wound size to minimize the size required for a split thickness graft due to concern of donor site morbidity.
Discussion: Scleroderma skin ulcers are rare but challenging wounds to treat due to pathognomonic presence of inflamed and compromised cutaneous tissue quality. Further, these skin lesion can be extremely painful and debilitating for patients which can lead to increased narcotic use and poor quality of life. This case report highlights initial findings supporting the use of OFM particulate and/or graft as a clinically effective treatment option to reduce inflammation, create a scaffold of robust, functional, viable, and granular neodermis, and ultimately shorten the time to definitive closure as well as to minimize the potential of recurrence of the scleroderma skin ulcer.
Trademarked Items: *Myriad™Matrix, Aroa Biosurgery Ltd, Auckland, NZ.
^Myriad™ Morcells, Aroa Biosurgery Ltd, Auckland, NZ.
References: Chaffin, A. E. and M. C. Buckley (2020). "Extracellular matrix graft for the surgical management of Hurley stage III hidradenitis suppurativa: a pilot case series." J Wound Care 29(11): 624-630.
Starnoni, M., M. Pappalardo, A. Spinella, S. Testoni, M. Lattanzi, R. Femino, G. De Santis, C. Salvarani and D. Giuggioli (2021). "Systemic sclerosis cutaneous expression: Management of skin fibrosis and digital ulcers." Ann Med Surg (Lond) 71: 102984.