Apligraf Case Study – Repigmentation
Patient: 57-year-old African-American female
Wound: Venous leg ulcer of 6 months duration
Prior Treatment: Inelastic compression therapy (Unna's boot)
The case presented here represents the experience of a single patient and may not be typical of all patients. Apligraf® should not be used on infected wounds or on patients with known hypersensitivities to any components of Apligraf. Please consult the complete prescribing information for a description of epidermal and dermal elements contained in Apligraf.
Preapplication
Day 0
Wound bed is fibrinous, with well-demarcated borders (A).
Surrounding skin is hyperpigmented and indurated (B).
Evidence of long-standing venous hypertension.
Application of Apligraf
Day 1
Apligraf is applied without sutures or staples, and trimmed to just slightly overlap wound edges.
Week 3
Reduction in wound area.
Wound bed is clean, granulation tissue; ulcer is filling in, formation of dermal layer is apparent
Week 6
Epithelization is occurring.
Week 13
New epidermis is visible; marked reduction in ulcer size.
Week 21
Wound is fully healed. Repigmentation and remodeling of skin is occurring*
No reulceration at follow-up visits
*Apligraf does not contain melanocytes, Langerhans' cells, macrophages, and lymphocytes, or other structures such as blood vessels, hair follicles, or sweat glands.