Abstract
The healing of venous and arterial ulcers is slow, and in some cases, they may not heal at all. This study aims to demonstrate the clinical advantage of Nevelia®, an innovative collagen dermal template substitute (DS) in venous and arterial chronic ulcers treatment. 35 patients affected by chronic vascular ulcers with a mean area of 35.1 ± 31.8 cm2 were treated with DS followed by autologous dermal epidermal graft (DEG). Follow-up was performed at 7-14-21 and 28 days after DS implant and 7-14-21 and 28 days after DEG. At 28 days after DEG, the mean values of Manchester Scar Scale was of 1.8 ± 0.7 for skin color, 1.6 ± 0.7 for skin contour, 1.7 ± 0.7 for distortion, and 1.7 ± 0.7 for skin texture, whereas skin was matte in 27 patients (77%) and shiny in the remaining eight cases (23%). Histological findings correlate with the clinical result showing a regenerated skin with reactive epidermal hyperplasia and dermal granulation tissue after two weeks (T1), and after three weeks (T2) a re-epithelialization and a formed new tissue architecture analogue to normal skin physiology. These data suggest that Nevelia® could be useful to treat chronic venous and arterial ulcers.
Highlights
Vasculogenic ulcers are the most common type of ulcers in the legs
This study aims to demonstrate that Nevelia®, an innovative collagen dermal template substitute, can be used successfully in burns and traumatic ulcers [32] and in vasculogenic chronic ulcers non-responder to conventional treatments
From January 2015 to September 2018, 35 patients affected by vasculogenic chronic ulcers localized on the inferior limbs (17 patients affected by venous ulcers, 11 patients with arterial ulcers and seven patients with mixed arterial/venous ulcers) were treated with the application of collagen dermal substitute template (DS) Nevelia® followed by the autologous dermal-epidermal graft (DEG) (Nevelia® Protocol: dermal template substitute (DS) + dermal epidermal graft (DEG)) at the Department of Plastic and Reconstructive Surgery, University of Rome, “Tor Vergata”, Italy
Summary
Vasculogenic ulcers (venous, arterial, and/or both) are the most common type of ulcers in the legs. They are chronic and may last from weeks to years [1,2] and show high recurrence rates [3]. Of these ulcers, 50% return within 10 years and 20% of patients experience 10 or more ulceration episodes, and 9.3% develop more than one ulcer in both legs [4]. 1–3% of the population is affected and the prevalence grows with age [13,14,15]
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