Factors that Influence Healing in Chronic Venous Ulcers Treated with Cryopreserved Human Epidermal Cultures

Abstract

background. Cryopreserved epidermal cultures (CEC) offer an "off the shelf" treatment for chronic wounds. These cultures are derived from neonatal foreskin and grow rapidly in vitro to form epidermal sheets. They do not require a biopsy from the patient, an advantage compared to autografts. They seem to act as a biological dressing, stimulating epithelialization from the wound edges and adnexae, probably through growth factor release. objective. To summarize our recent experience with the use of CEC in chronic venous leg ulcers and to determine the factors that influence healing in chronic venous ulcers treated with CEC. patients and methods. A single arm, open label study including a total of 11 patients with documented venous ulcers was per-formed. The study involved the application of cryopreserved epidermal cultures every other week to nonhealing leg ulcers for a total of 12 weeks or until complete healing of the ulcer. results. A total of 11 patients with one or more leg ulcers were treated. The average age was similar in healed and unhealed groups. Seven patients completely healed after an average of 4.14 CEC applications. Four patients did not heal after a total of 12 CEC applications. conclusion. Predictors for failure to heal after CEC application in our patients were long wound duration, wound size, presence of lipodermatosclerosis, and history of failed prior split-thickness skin grafts.

The accuracy of venous leg ulcer prognostic models in a wound care system

“…Several studies by other authors have also shown that wound size and wound age are good prognostic markers 5,14–17 . These studies reported risk factors for not healing and, as a result, these models are not strictly prognostic models 31 .…”

“…The discriminative ability of these models as assessed by the area under the receiver operator characteristic (AROC) curve was excellent (> 0.80). Although not published as truly part of prognostic models, several other authors have also found these parameters to be important for estimating the prognosis of a venous leg ulcer 5,14–17 …”

“…The other studies have also been from single settings or have been based on subjects seen in multicenter clinical trials. In addition, even the largest of these studies have evaluated fewer than 500 individuals with venous leg ulcers 5,14–17 …”