(CS-035) Bioactive Glass Skin-Substitute Matrix Facilitates Pain Reduction and Healing for Patients with Pyoderma Gangrenosum Ulcers

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease, commonly associated with severe pain and tenderness, with devastating effects on patients’ lives. Treatment is challenging and involves managing inflammation and pain, balanced with optimized wound care. Therapies typically target a broad spectrum of immunologic mediators and inflammatory cells shown to be involved in PG, including cytokines, neutrophils, and lymphocytes. A novel borate-based bioactive glass wound matrix* (BGWM) has been shown to promote healing in complex chronic wounds by improving angiogenesis, increasing metabolic activity and cell proliferation, and reducing bioburden. These bioactive glasses are biocompatible water-soluble materials, formulated to quickly degrade in a wound. We report our outcomes with use of BGWM in chronic PG ulcers that had failed numerous prior treatments over a prolonged duration.

Methods:

Three patients with 8 PG ulcers were treated. Wounds were cleansed with a sterile wound cleansing solution. The matrix was shaped to fit the size of the ulcer and placed in direct contact with the wound surface. Either a non-adherent dressing and alginate or a super-absorbent foam dressing and gauze were used as cover dressings to absorb exudate and secure the BGWM. BGWM was reapplied once per week.

Results:

Patient ages ranged from 49 to 61. One ulcer was 89 days old, and the remaining 7 ulcers were over 7 years old prior to BGWM application. Mean ulcer volume at start of BGWM was 5.6 cm³ (range: 0.4 cm³ - 22.8 cm³).  After the third application of the matrix, patients reported a large reduction in pain, and in the last weeks of therapy, patients reported no pain or minimal pain. All ulcers were closed with use of BGWM after a mean time of 12.8 weeks.

Discussion:

In this series of complex PG patients with multiple comorbidities, adjunctive use of BGWM was successful in facilitating closure of all ulcers, some of which had been present for over 20 years. Patients also reported a drastic reduction in pain and improved quality of life during and after use of BGWM.

Trademarked Items: *MIRRAGEN Bioactive Glass Wound Matrix, ETS Wound Care, Rolla, MO

References: 1. Gameiro A, Pereira N, Cardoso JC, Gonçalo M. Pyoderma gangrenosum: challenges and solutions. Clin Cosmet Investig Dermatol. 2015;8:285-93.
2. Armstrong DG, Orgill DP, Galiano RD, et al. A multi-centre, single-blinded randomised controlled clinical trial evaluating the effect of resorbable glass fibre matrix in the treatment of diabetic foot ulcers. Int Wound J. 2022;19:791-801.
3. Jung S, Day T, Boone T, et al. Anti-biofilm activity of two novel, borate based, bioactive glass wound dressings. Biomed. Glasses 2019;5:67–75.
4. Rahaman MN, Day DE, Bal BS, et al. Bioactive glass in tissue engineering. Acta Biomater. 2011;7: 2355-2373.
5. Mehrabi T, Mesgar AS, Mohammadi Z. Bioactive Glasses: A Promising Therapeutic Ion Release Strategy for Enhancing Wound Healing. ACS Biomater Sci Eng. 2020;6:5399-5430.