APPLICATION OF KERECIS GRAFTS IN NUTRITIONAL SKIN FAILURE SYNDROME: A CASE SERIES
Dr. Naz Wahab, MD, Wound Care Experts
In the two case studies below, Dr. Naz Wahab, MD, uses weekly Kerecis (cellular, acellular, matrix-like products, or CAMPs) applications on chronic wounds to achieve wound closure. Dr. Wahab utilized SnapshotNIR, a near-infrared spectroscopy (NIRS) imaging to ensure CAMPs adherence and wound bed tissue oxygenation increases throughout the duration of the treatment plan.
The growing incidence of chronic non-healing wounds in aging and indigent populations may result from a culture of poor nutrition, in what Dr. Wahab refers to as Nutritional Skin Failure Syndrome.
Dermal and surgical application of minimally intact Kerecis grafts allows for the deposition of collagen and fatty acids to the wound, aiding in an anti-inflammatory response and providing nourishment to the skin - an environment that initially led to the chronic wound.
SnapshotNIR was used to validate that the circulation and tissue oxygenation in the wound bed and peri-wound would support the successful application of the Kerecis CAMPs.
CASE 1
Patient Details
71-year-old male
Medical History: hypertension, peripheral arterial disease, coronary artery disease, cardiothoracic surgery and three endovascular procedures with balloon angioplasty and stent placements to lower limb
Wound History: history of right foot chronic wound, patient had increased pain and erythema on the right foot
Prior Wound Care/Treatment: amino products, hyperbaric oxygen therapy (HBOT), debridement; patient unable to tolerate HBOT due to pain
Kerecis Application: weekly Kerecis applications
Case 2
Patient Details
92-year-old female
Medical History: peripheral vascular disease, hypertension, coronary artery disease, hyper cholesterol, type 2 diabetes; multiple endovascular revascularization procedures with angioplasty and stents
Wound History: left achilles tendon ankle wound and a right great toe wound
Prior Wound Care/Treatment: multiple application of amniotic tissue; aggressive debridement
Kerecis Application: weekly Kerecis applications
Case Results
Based on the tissue oxygenation data obtained from SnapshotNIR, in both cases, the wound improved by Day 7 post-Kerecis graft application, and continued to improve with weekly Kerecis applications to Day 21. Each wound showed improved blood flow and delivery of oxygen-rich nutrients to the skin, which aided in the wound healing process.
How does SnapshotNIR help with CAMPs Application?
Oxyhemoglobin and deoxyhemoglobin trends can indicate if a wound bed is prepared through adequate debridement. Using the wound sizing feature and StO2 of the scanned area from SnapshotNIR, you can ensure the right size of CAMP is used and applied, reducing product waste. SnapshotNIR can identify angiogenesis after a CAMP application, confirming clinical judgement regarding wound prognosis.
Using serial imaging, Dr. Wahab could track and document the wound with photographic evidence of the wound improvement. The objective data allowed Dr. Wahab to see that each wound bed was prepared for the Kerecis graft application and confirm tissue granulation for a successful healing outcome.
Treating the nutritional depletion of these wounds may be useful both topically and systemically for the patient to achieve wound closure.
To achieve CAMPs application success, having a streamlined process for your facility and clinicians can improve workflows.
To learn more about how using SnapshotNIR can make your CAMPs applications cost-effective, watch this video with Kent Imaging CMO, Dr. Jeffrey Niezgoda, MD.