In advanced wound care, the standard approach is often to add more therapies. However, a recent case study by NOMS podiatric surgeon Michael Canales, DPM, demonstrates that the key to healing a stubborn wound can actually be subtraction.
Reflecting on the success of this approach, Dr. Canales shared:
"Honored to receive the Aurora Clinical Excellence Recognition and to present in Reykjavik, Iceland. Grateful to Kerecis for the opportunity and especially honored to have met former Prime Minister Jóhanna Siguroardóttir."
Here is how cutting out the "therapeutic noise" healed a chronic, two-year-old wound in less than four months.
The Challenge: A High-Risk Case
The patient was a 38-year-old male with multiple high-risk conditions:
- Type 1 diabetes
- Early kidney disease
- Microvascular disease
He suffered from a two-year-old chronic wound on his anterior ankle. Because of poor blood flow and constant motion, this location is notoriously difficult to treat. The wound had already failed numerous standard and advanced interventions, including multiple dressing changes and hyperbaric oxygen therapy.
The Strategy: Pure Biology over Complex Machinery
Dr. Canales pivoted away from complex, multi-modal therapies. He hypothesized that the biological properties of the Kerecis graft would be sufficient to drive healing on its own if all other variables were eliminated.
The minimalist intervention relied strictly on the Kerecis graft as an active biological contributor, using just two applications:
- One sheet graft
- One morselized graft
To isolate the effect of the Kerecis biology, all other advanced treatments were intentionally withheld. This included negative pressure wound therapy, external fixators, and complex dressings. The protocol was simplified to the bare essentials: the Kerecis graft, simple 4x4 gauze sponges, gauze roll, and an elastic compression wrap.
The Verdict: Full Wound Closure
The strategy was entirely successful. By restricting the protocol to only the graft, gauze, and compression, the patient achieved full wound closure in just under four months.
This outcome validates that the biological agent was the core driver of success. Additional therapies were not only unnecessary, but were potentially "noise" that interfered with the healing process.
