• Shinichiro Kawamoto, Eriko Shinkawa, Susumu Fujiwara, Yoshiko Oda, Haruki Jimbo, Eiji Nakano, Takeshi Fukumoto, Ryusuke Ono, Takahiro Yasuda, and Hironobu Minami.
• Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Hyogo, Japan.
• Medicine (Baltimore). 2023 Nov 17; 102 (46): e36134e36134.

IntroductionThe healing of recurrent and refractory skin ulcers requires a long time, during which there is risk of infection, and hospital admission is occasionally required for surgical or daily conservative treatment. Therefore, the development of promising treatments that promote faster, uneventful healing is a must. Composed of cryoprecipitate and thrombin, fibrin glue has a history of surgical use for preventing bleeding and spinal fluid leakage. Moreover, in-house cryoprecipitates contain higher concentrations of coagulation factors and cytokines that may enhance wound healing than commercially available products. However, the efficacy of completely autologous fibrin glue (AFG) in tissue repair has not yet been fully demonstrated.Patient ConcernsThis study aimed to evaluate the efficacy of AFG in the treatment of refractory skin ulcers in comparison with the conventional treatment.DiagnosisTwo patients with skin ulcer on their lower extremities due to trauma or scleroderma who showed resistance to conventional treatment were included in the study. Both study participants were diagnosed with refractory skin ulcer and were ineligible for autologous skin transplantation.InterventionsAFG was prepared following autologous blood donation using a Cryoseal® system. Subsequently, AFG was administered to 50% of the area of each ulcer and observed for 4 weeks in comparison with recombinant basic fibroblast growth factor with bucladesine sodium treatment that was administered to the rest of the ulcer.OutcomesThe skin ulcer after trauma in participant 1 showed better improvement in the AFG-treated area. Although AFG did not show superiority regarding the ulcer area of a patient with scleroderma, it guarded the continuous exudation from the edge of the swollen skin surrounding the ulcer.ConclusionAFG showed effective and beneficial results for wound healing of refractory skin ulcer and prevented exudation without any severe adverse events.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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