The Use of Autologous Multilayered Leukocyte, Platelet, and Fibrin Patch as a First-line Defense: Why Wait?

Introduction: In a wound care center, conservative treatment is often the first option to treat diabetic wounds before considering advanced mo- dalities. When those conservative treatments fail, then advanced thera- pies are considered. With the autologous multilayered leukocyte, platelet, and fibrin (MLPF) patch, there is no need to use conservative treatments initially. Instead, the MLPF patch can be started as a first-line defense, thus healing patients quicker, offering the patient’s own cells to eliminate risk of rejection, optimizing healing outcomes, potentially saving limbs, while saving valuable dollars on the wrong treatment. Methods: In three separate wound care centers, the MLPF patch was considered immediately to treat chronic diabetic wounds. This allowed faster wound healing and dramatically decreased the potential for the development of complications, such as infection or subsequent surgical procedures. Data collected included chronicity of wounds, previous tried and failed therapies, as well as wound dimensions. Results: One patient had a history of a right BKA and impaired vascular status. The patient presented with a left 2nd toe infection and underwent amputation of 2nd and 3rd toe due to osteomyelitis. Due to failed revascularization, the patient was referred to a limb salvage center for a potential BKA. The patient declined and sought treatment at our wound center. The MLPF patch was initiated on 7/5/24 and the wound achieved full closure after 7 MLPF patches. No further amputa- tion was required. Another patient with diabetes presented with burn wounds to the lower leg which failed initial split thickness skin grafts. The patient was referred to the wound center where the MLPF patch was initiated at his 2nd visit; the wound decreased from 96 cm2 to 60 cm2 after just 4 applications and the patient is still undergoing therapy. One final patient had a surgical debridement on 3/21/23 of an infected plantar ulceration and subsequently had a 1-month nursing facility stay for IV antibiotics of underlying osteomyelitis. The patient achieved full closure after 5 applications of the MLPF patch without further complication. Discussion: A recent study by Musuuza, et. al. documented that “nearly 2 million Americans develop a diabetic foot ulcer each year; within 5 years of ulceration, 5% will undergo major amputation.” The MLPF patch has been shown to dramatically decrease the risk of major amputation and decrease morbidity in patients with chronic diabetic wounds and should be considered as a first-line treatment in the efforts to save diabetic limbs.