Abstract


Introduction: When wounds do not respond to standard treatments, advanced therapies are recommended. One such therapy, a proprietary synthetic peptide, self-assembles into a wound matrix when applied to a wound to provide a physical-mechanical barrier that mitigates contamination, modulates inflammation, and becomes a scaffold for cell proliferation and growth. This study evaluated the safety and performance of the AC5 ® Advanced Wound System (Arch Therapeutics Inc. Framingham, Massachusetts) in the management of long-duration, non-healing, and challenging acute and chronic wounds that failed prior therapy.
Materials and Methods: Fifteen participants were assigned to receive treatment with AC5 ® weekly or every other week. AC5 ® was evaluated for ease of use, and participants were evaluated for wound condition, healing progress, and local and systemic adverse reactions. Results: 64% of participants treated weekly had a >50% reduction in wound area at four weeks and 73% had a >60% reduction at eight weeks. For patients treated every other week, 25% achieved 50% wound area reduction at four weeks and 50% had a >50% reduction at eight weeks. The product was easy to apply contiguously to uneven wound geometry. There were no adverse events.
Conclusion: The synthetic self-assembling peptide wound matrix was shown to be safe, effective, and simple to use in the treatment of hard-to-heal wounds. Because AC5® is easy to apply, has an unusual ability to self-assemble into a wound matrix in vivo, and affixes itself contiguously to the interstices of the tissue, AC5 ® may be particularly useful for undermined and tunneled wounds, whether acute or chronic. The results of this study imply that a once-weekly application may result in the best outcome. Further studies are suggested to confirm optimal application frequency for different wound types.

Abstract


Introduction: Chronic wounds, burns, and traumatic injuries present significant clinical challenges due to infection risks, delayed healing, and complications such as scarring. Advanced wound care has evolved with the development of skin substitutes, categorized into biologic and synthetic matrices. Synthetic skin substitutes have gained popularity due to their reduced risk of disease transmission, cost-effectiveness, and ability to enhance wound healing through structural support and bacterial biocidal properties.
Materials and Methods: This review uses the Centers for Medicare and Medicaid to identify unique synthetic skin substitutes. Each company was contacted to obtain details about their respective products, including their composition, mechanisms of action, clinical applications, and advantages. Studies, case reports, and clinical trials from the PubMed database, Google Scholar, and ClinicalTrials.gov were also assessed to compare the effectiveness of these products in managing acute, chronic, and complex wounds.
Results: The review found that synthetic skin substitutes offer several key advantages in managing chronic and complex wounds. These substitutes enhance wound healing by promoting cell migration, granulation tissue formation, and angiogenesis. They are also associated with improved cosmetic outcomes, reduced infection risks, and quicker wound closure. Many of the products reviewed demonstrated significant improvements in healing rates, with some showing faster recovery than traditional treatments. Additionally, the synthetic materials reduced the need for frequent dressing changes and minimized discomfort for patients. Overall, the results indicate that synthetic skin substitutes effectively improve wound care outcomes across various wound types.
Conclusion: While synthetic skin substitutes offer promising outcomes in wound management, limitations such as high initial costs and the need for further research persist. Nonetheless, their ability to reduce infection risks, accelerate healing, and improve patient comfort makes them a valuable alternative to traditional biologic substitutes. Future studies should focus on long-term cost-effectiveness and broader clinical applications to validate their widespread use.

Abstract


Thermal or burn injuries cause coagulative necrosis of the epidermis and underlying tissues and the resultant wounds can be long lasting and highly painful. Depending on the depth of a burn, management ranges from local wound care to surgical intervention. When presented with deep-partial thickness and full-thickness burns, autologous skin grafting has been the mainstay of management to prevent scarring and promote healing. However, since the early 2000s, there has been increasing interest in reducing, if not eliminating, the need for autologous grafting considering the morbidity and pain associated with donor site harvesting, lack of appropriate donor sites in the case of larger burns, and to improve overall cosmetic outcomes. In this article, we discuss the available products on the market for the treatment of thermal burn injuries, explore the data advocating for their use and discuss their limitations, and highlight the unique efficacy of intact fish skin grafts, in particular, in this specific patient population.

Abstract


Chronic wounds are notoriously challenging to heal as they are often halted in their normal healing process. The concept of TIME (Tissue, Inflammation/Infection, Moisture imbalance, Epithelial edge advancement) has been widely utilized in clinical practice to prepare wound beds and promote healing, particularly in longstanding wounds. Traditional methods of wound bed preparation are often inadequate in healing chronic wounds or they may not be tolerated by patients. A variety of interventions have been developed in recent decades to address these components and improve chronic wound outcomes. Evolutions in tissue preparation include emerging enzymatic debridement agents and ultrasound-assisted debridement. Wound infection can be managed through a variety of new methods including advanced wound dressings, surfactants, and fluorescence imaging. Portable negative pressure wound therapy devices provide a new, convenient method for exudate management. Finally, epithelial advancement can be enhanced with technologies such as cellular, acellular, and matrix-like products (CAMPs), topical medications, and electrical stimulation.