168 Coverage of Exposed Bone in Pressure Ulcers with a Fibroblast-Populated Construct Decreased Healing Time Compared to Controls in a Pilot Randomized, Control Trial

Abstract

Patients who are hospitalized, elderly, or have spinal cord injury develop stage IV pressure ulcers in sacral, ischial, and trochanteric regions. Bone exposure of these pressure ulcers becomes a significant clinical problem. We propose that treatment of exposed bone with bone resection and a fibroblast-populated construct (FPC)(Dermagraft) accelerates healing. Four patients with stage IV sacral or ischial pressure ulcers where randomized to the control group and underwent bone resection with wet-to-dry dressing changes. Four other patients were randomized to the treatment group and underwent bone resection with application of FPC. Both groups were clinically monitored and treated with culture-specific antibiotics. The data showed that patients treated with FPC had their exposed bone covered after an average at 2.25 weeks, while the control groups required at least 4 weeks for bone coverage. Therefore, the preliminary data suggest that FPC is effective in reducing the time of bone exposure after sacrectomy/ischiectomy in pressure ulcer surgery. Acknowledgments: University of Michigan internal funding and Veterans Administration