Bioabsorbable Borate-based Glass Fiber Matrix Usage in Diabetic Foot Wound Closure Post Surgical Intervention

Introduction: 47-year-old male presented to the ED, and our service was consulted to see the patient for a diabetic foot infection. He is Diabetic with peripheral neuropathy so he states he never noticed the wound or causing any pain. He stated he went to the ER when he noticed the wound became malodorous with increased drainage and increased swelling to the right foot and had presented with some chills. He had presented with a plantar aspect right forefoot full thickness ulceration measuring 3.5 cm x 4 cm x 4.5 cm which tunneled plantar to proximal with crepitus and gas gangrene was noted in the foot. Methods: Patient was taken to the OR for an emergent washout for primary control of osteomyelitis infection and gas gangrene. X-rays were taken post-operatively and still there was some signs of crepitance noted and gas on film and MRI confirmed 4th and 5th rays consisting of osteomyelitis ,so he was taken again to the OR for debridement of all non-viable bone and soft tissue in which the second time 4th and 5th ray resections were performed. Then started NWPT post-operatively to optimize the physiology involved in wound healing by applying sub- atmospheric pressure to help reduce inflammatory exudate and promote granulation tissue. Patient has been on NWPT for about 7-8 weeks consisting of 3x weekly changes which were done with in house with our Podiatry service and wound care team. Results: Skin substitutes were then discussed with patient to help achieve wound healing. Started to apply glass graft for our patient and patient agreed to proceed with the application of the graft. Each office visit, wound debridement was done and five applications of the graft were applied to the wound Discussion: Mirragen® Advanced Wound Matrix is intended for the management of acute and chronic wounds, including: partial- and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/grafts, post-Mohs surgery), post laser surgery, podiatric wounds, wound dehiscence, trauma wounds (abrasions, lacerations, first- and second-degree burns, skin tears), and draining wounds. With continued discussion of using this spe- cific type of glass graft in healing complex diabetic lower extremity wounds in wound care and podiatry could lead to increased aware- ness and aid in potentially healing chronic non-healing wounds and surgical wounds the future. CR-069 (RPT-001) Pediatric Chronic Wounds: A Novel Analysis from a Tertiary Care Center Ayesha A. Qureshi, MD; Catherine Kennedy, BHSc; Michael Nieveras, BS; Kaylee Leathers, MD; Josh Bricker, PhD; Jenny Barker, MD, PhD Introduction: 10.5 million Americans suffer from chronic wounds annually. While extensively studied in adults, pediatric chronic wounds receive limited attention, relying on adult-centric approach- es and anecdotal evidence. Our study is among the first to describe the prevalence and demographics of pediatric chronic wounds, evaluate wound presentations including etiologies, comorbidities, anatomical locations, and encounter types; and examine the socio- economic disparities influencing their development. Methods: We conducted a retrospective analysis of visits for wounds at a tertiary pediatric hospital in 2023, based on a coding schema including 9,326 pre-determined ICD-10 codes. Patients under age 26 with >2 visits and diagnosed chronic wounds lasting >90 days were included. Socioeconomic disparities were evaluated using the Childhood Opportunity Index (COI). Linear mixed-effects logistic regression models examined the relationships between COI scores, race and wound characteristics. Results: We identified 1,368 unique visits among 367 chronic wound patients. Median age at first visit was 12(IQR:6–15.5), 55.6% were male, 71.4% White, and 45.0% had public insurance. Most prevalent wounds included open lacerations (20.3%), osteomyelitis (20.0%), burns (14.2%), traumatic (7.3%), pilonidal (5.0%), and pres- sure injuries (4.9%). Comorbidities were notable for osteomyelitis (27.8%), cerebral palsy/paralytic syndromes (8.0%), myelomenin- gocele (6.6%), vitamin deficiencies (6.1%), and immunodeficiencies (6.0%). Anatomical locations were primarily upper (30.5%) and lower extremities (30.2%). Encounters were primarily through office visit (71.3%), occupational therapy (10.1%) and physical therapy (7.2%). COI quintile distribution was very low (13.9%), low (17.1%), moderate (24.7%), high (20.6%), and very high (23.7%). Regression demonstrated COI scores were not associated with wound develop- ment and race was not associated with wound severity. Of those who had pressure injuries, stage III (25.0%) and IV (21.9%) were most common. 60% of stage III cases had a low or very low COI, suggest- ing potential disparities which may affect timely interventions. Discussion: Building on our prior national analysis, this study highlights a high prevalence of pediatric chronic wounds with distinct etiologies and comorbidities. Many of these patients face socioeconomic challenges and present at late stages. Our ongoing research thus includes a prospective trial investigating multidisci- plinary wound presentations and healthcare barriers to develop best practice guidelines for this vulnerable group.