(CS-009) Microvascular Tissue Improves Perfusion and Drives Healing in a Series of Mohs Surgical Defect Cases

Mohs surgery is the gold standard technique to remove cancerous lesions from the skin.¹ Risk factors such as ongoing chemotherapy and/or radiation treatment, diabetes, or peripheral vascular disease may lead to a dysfunctional local microcirculation, which, along with the size and depth of the defect, patient age, and other factors may cause the post-surgical skin defect to be at greater risk for not healing. In such cases, proactive use of an advanced wound care treatment may be warranted. Here we report on real-world clinical experience with a structural tissue allograft composed of microvascular extracellular matrix (PMVT*) in a series of four challenging at-risk Mohs defects. 


Methods: Patient 1 was a 51-year-old male with coronary artery disease, hypertension, nicotine dependence, and post-COVID pulmonary issues who presented with a 0.4cm deep 13cm² defect on his right scapula 5 weeks after carcinoma excision. Patient 2 was a non-compliant 80-year-old female former smoker who presented with a 6cm² defect on her left leg following carcinoma excision. Patient 3 was a 59-year-old female with coronary artery disease, chronic heart failure, COPD, and obesity who presented with a 15.5cm² defect on her right leg after carcinoma excision. Patient 4, a 70-year-old female with COPD and prior nicotine dependence, presented with a 0.5cm deep 3cm² left leg defect post-carcinoma excision. PMVT was topically applied weekly to the wounds, then covered with a nonadherent dressing and standard outer bandages. Defect size and appearance were assessed weekly, and near-infrared (NIR) spectroscopy images taken to assess tissue oxygen saturation.

Results: In all four cases the wounds fully healed, with the patients requiring between 3 to 9 topical PMVT applications prior to closure. The healing defect sites became progressively more vascularized during the course of treatment, correlating to the NIR images.

Discussion: PMVT has previously demonstrated increased healing and wound perfusion in a 100-subject randomized controlled trial on Wagner 1/2 DFUs,² and shown the clinical capability to support angiogenesis and change the trajectory of healing towards wound resolution.^3-7 Improvement of perfusion in these challenging Mohs wounds are indicative of PMVT’s capacity to assist microvascular tissue reconstruction and foster complete healing.

Trademarked Items: *mVASC® – MicroVascular Tissues, Inc., San Diego, CA

References: 1) Bowen GM, et al. Mohs micrographic surgery. Am Fam Physician. 2005;72:845-848.
2) Gould LJ, et al. Improved healing of chronic diabetic foot wounds in a prospective randomised controlled multi-centre clinical trial with a microvascular tissue allograft. Int Wound J. 2022;19(4):811-825.
3) Arnold JF, et al. In-Depth Assessment of Perfusion Outcomes with Microvascular Tissue in a Diabetic Foot Ulcer Clinical Study: Sub-Group Analysis of the HIFLO Trial. SAWC Fall 2021.
4) Dobke M, et al. Reactivation of the Clinically Senescent Wound Using a Novel Microvascular Tissue Graft in Complex Lower Irradiated Leg Wounds. SAWC Spring 2019, CS-018.
5) Dobke, M.

Case Report: Treatment of a Lower Leg Defect in the Course of Sarcoma with Microvascular Tissue. Wounds. 2023;35(5):E154-E159
6) Arnold J. Stimulation of Perfusion and Healing Using Microvascular Tissue in a Series of Refractory Complex Diabetic Wound Cases. SAWC Spring 2023. CS-009.
7) Dobke M, et al. Microvascular tissue as a platform technology to modify the local microenvironment and influence the healing cascade. Regen Med. 2020;15(2):1313-1328.