(CS-086) A Multicenter Case Series Evaluating a Therapeutic Stack of Autologous Multilayer Leukocyte-Platelet-Fibrin Patch and Hyperbaric Oxygen Therapy for Complex Wounds

Friday, April 10, 2026

Andrea Rachel, RN, WCC – Clinical Nurse Manager, Wound Care, Healogics/NRMC

Introduction: Chronic wounds are frequently characterized by impaired perfusion, tissue hypoxia, and prolonged inflammation, resulting in delayed healing and increased risk of limb loss. Autologous multilayer leukocyte-platelet-fibrin (MLPF) patches provide a biologic scaffold with sustained growth factor release and immune modulation, while hyperbaric oxygen therapy (HBOT) enhances tissue oxygenation and supports cellular repair. This therapeutic stack targets both the local wound microenvironment and systemic hypoxia. Adequate oxygen delivery is essential for angiogenesis, fibroblast proliferation, and collagen synthesis, yet chronic ischemic wounds experience persistent hypoxia and nutrient deprivation that disrupt repair mechanisms. Limited clinical data exists combining HBOT and MLPF patch therapy in complex wounds.

Methods: This case series evaluated seven patients with complex wounds treated at two wound care centers. Wound etiologies include diabetic foot ulcers with and without osteomyelitis, post-amputation wounds, chronic traumatic wounds, and radiation-associated soft tissue injury. Patients received serial applications of an autologous MLPF patch prepared exclusively from the patient’s own blood without exogenous additives, combined with adjunctive HBOT. Treatment sequencing, frequency, and duration varied between centers. Outcomes were assessed observationally and included percentage wound area reduction, qualitative changes in wound bed appearance, coverage of exposed structures, time to healing, and limb salvage.

Results: Across seven patients, combined autologous MLPF therapy and HBOT were associated with progressive wound improvement despite prolonged wound duration, exposed bone or soft tissue, chronic infection, and significant comorbidities. Four wounds achieved complete epithelialization; two wounds achieved greater than 90% healing at the time of analysis, and one wound remained in active treatment with approximately 50% closure. Coverage of previously exposed bone or structures was observed in all applicable cases. Limb salvage was achieved in all patients where amputation was considered a clinical risk. Two patients remained in treatment at the time of abstract submission with ongoing improvement.

Discussion:

In this case series, combining an autologous MLPF patch and HBOT demonstrated favorable healing trajectories in complex wounds refractory to standard care. The physiologic synergy of autologous biologic therapy and enhanced tissue oxygenation may represent a promising adjunctive strategy in advanced wound management. Larger prospective studies are warranted to further define clinical outcomes and optimize treatment protocols.