Apligraf Case Study – Anchoring
Patient: 71-year-old male
Wound: Venous leg ulcer of 6 months' duration
Prior Treatment: Inelastic compression therapy (Unna's boot) DuoDerm® dressing, and Metrogel®
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.
Preparation
Day 0
Suboptimal wound bed–fibrinous (A).
Poorly demarcated, macerated borders (B).
Evidence of long- standing venous insufficiency (C).
Apligraf is fenestrated and attached with sutures (A).
Suture is within margin of wound (B).
Week 1
A firm protective layer has formed (A).
Yellow fibrinous appearance of Apligraf may be normal unless there are clinical signs of infection.*
Week 4
Epithelization is occurring.
Marked reduction in size and depth of the ulcer.
New ulceration developing superiorly (A).
Central portion of the wound has closed (B).
Week 12
Apligraf® is applied to new ulcer (A) and reapplied (physician's preference) to remaining open areas of original ulcer (B).
Week 13
Central area of wound has fibrinous appearance (A).
Week 33
Wound is closed.
Tissue remodeling is continuing.
*Unless there are clinical signs of infection (pain, swelling, heat, redness, purulent discharge), the wound should be left alone, rebandaged, and reassessed at the next follow-up visit.
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