Replicine™ Functional Keratin® wound dressings absorb and interact with wound fluid to form a soft, hydrophilic keratin gel that facilitates a moist healing environment. A cell friendly structural framework is also provided to the wound, encouraging cell migration and differentiation.
See experts present informatoin on keratin wound care at the SAWC convention.
- Dr Rob Kelly introduces Replicine™ Functional Keratin® wound care technology.
- Dr Marjana Tomic-Canic discusses keratin biology and the role of keratin in epithelization.
- Dr Robert Kirsner discusses clinical experience in chronic wounds and epidermolysis bullosa.
Chronic wound care
Replicine™ Functional Keratin® treatment was used in a 22 patient case series of long duration mixed venous leg ulcers. 86% of nurses and 91% of patients indicated a preference for Replicine™ Functional Keratin® treatment over conventional therapy13 and 71% of large (>5cm2), long duration (>6 months) wounds healed7 compared to a historical expectation of 13% for this wound type (Margolis et al, Am. J. Medicine 2000).
Replicine™ Functional Keratin® treatment was also used in a 45 wound case series of mixed etiology chronic wounds, including venous leg ulcers and diabetic wounds. 87% of hard to heal wounds (>2 month duration) achieved a significant 76- 100% reduction in wound area.3
Burns treatment and donor sites
Faster epithelisation rates lead to faster wound closure and so reduced infection rates and a better healed outcome, including potentially less severe scarring and pigmentation effects. An 80 patient cohort study on partial thickness and superficial burns, compared burn management using keratin wound care with standard of care in the treatment facility. Burn patients, with an age range of 7 months to 69 years, had wounds treated with either keragelT®, keragel® or keramatrix® depending on location and exudate level of the wound. The keratin products were found to facilitate healing faster (mean healing time of 8.7 days compared to 14.4 days) with minimal permanent skin change or scarring reported for the treatment group. The keratin products were well tolerated with minimal pain and itch, a common issue at dressing change. The keratin treatments were easy to use and administer for the health professionals in both outpatients and community settings and a cost of care analysis showed a 47% cost saving compared to the control group.1
A randomized, blinded, controlled study of 26 split skin graft donor site wounds showed a statistically significant improvement in epithelization rate with use of Replicine™ Functional Keratin® compared to standard care control. Improved healing rate leads to an estimated 2 day improvement in healing time and associated reduction in risk of infection, hypertrophic scarring and other complications.6
Substantial improvement in skin structure and robustness is reported in the use of Replicine™ Functional Keratin® to treat the severe blistering disorder epidermolysis bullosa, a condition with currently no effective treatment.
Quality of life is improved and cost of care is also signficantly reduced.2, 9, 12
Improvements of 26% in the rate of epithelialization of acute wounds have been identified in studies on Replicine™ Functional Keratin® advanced wound care technology conducted by the University of Miami10 in a porcine model. Related analysis of protein expression indicated that keratinocytes in the treatment group entered the activated phase and migratory phase sooner than the positive control group. Related studies have demonstrated in increase in production of important basement membrane proteins occurs in the presence of Replicine™ Functional Keratin®.11 These events combine to create an environment that closes wounds faster and leads to more robust healing and better cosmetic outcome.
In a 20 patient clinical case series of skin tears treated with Replicine™ Functional Keratin® in a community setting carers consistently reported faster healing rates, stronger and more robust skin and improved cosmetic appearance of the healed wound relative to standard care for this wound type.39
How it works
Replicine™ Functional Keratin® wound dressings facilitate a moist wound healing environment and manage wound exudate in an appropriate manner while delivering Replicine™ Functional Keratin® proteins to the wound bed.
Replicine™ Functional Keratin® proteins have been shown to activate keratinocyte cells present in the wound and to stimulate them to quickly enter a hyperproliferative phase, an essential phase for wound healing.10 Proliferation and migration of keratinocyte cells is often the limiting process for epithelization and wound closure and activation and stimulation of keratinocytes accelerates epithelization and results in good wound healing. Acceleration of epithelization has been measured in vitro and in vivo. In addition University of Miami research demonstrates Replicine™ Functional Keratin® can increase the expression of collagen 4 and collagen 7 in keratinocytes.11 These basement membrane collagens join the dermal and epidermal junction and build a robust, healed skin surface. The dramatic impact on hard to heal wounds and skin robustness in the condition epidermolysis bullosa can be attributed to this mechanism. The natural role that keratins play in the wound healing process is given in Kim et al, Nature. 2006 May 18;441 (7091):362-5 and Omary and Ku, Nature. 2006 May 18;441 (7091) :296-7.
Peer Review Publications
- F Loan, C Marsh, S Cassidy, J Simcock, Keratin-Based Products for Effective Wound Care Management in Superficial and Partial Thickness Burns Injuries, Burns, (2016), http://dx.doi.org/10.1016/j.burns.2015.10.024. http://www.ncbi.nlm.nih.gov/pubmed/26787130
- J Denyer, C Marsh, R Kirsner Keratin gel in the management of epidermolysis bullosa, Journal of Wound Care, 2015, Vol 24, No 10, pp446-450. http://www.ncbi.nlm.nih.gov/pubmed/26488735
- A. Batzer, C Marsh, R Kirsner The Use of Keratin Based Wound Products on Refractory Wounds, Int Wound J, 2014 Feb 28. doi: 10.1111/iwj.12245 http://www.ncbi.nlm.nih.gov/pubmed/24580740
- N Jina, C Marsh, M Than, H Singh, S Cassidy J Simcock1 Keratin Gel Improves Poor Scarring following Median Sternotomy, ANZ Journal of Surgery, 2014 http://onlinelibrary.wiley.com/doi/10.1111/ans.12520/abstract
- G Sussman, Advances in Wound Dressing Technology, Wounds International, Dec 2013, vol 4, issue 4, p12-14. http://www.woundsinternational.com/pdf/content_11026.pdf
- A Davidson, N Jina, C Marsh, M Than and J Symcock, Do Functional Keratin Dressings Accelerate Epithelialization in Human Partial Thickness Wounds? A Randomized Controlled Trial on Skin Graft Donor Sites eplasty13e45 aug 2013. http://www.medscape.com/viewarticle/810610_2
- M P Than, R A Smith, C Hammond, R Kelly, C Marsh, A D Maderal, R S Kirsner. Keratin-based Wound Care Products for Treatment of Resistant Vascular Wounds. J Clin Aesthet Dermatol. 2012 Dec;5(12):31-5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533319/
- A C Vivas, A D Maderal, M P Than, R S Kirsner. Letter: Designing clinical trials to bring wound products to market Int Wound J. 2013 Feb;10(1):114-5. Epub 2011 Dec 14>. http://onlinelibrary.wiley.com/doi/10.1111/j.1742-481X.2011.00907.x/pdf
- R Kirsner, S Cassidy, C Marsh, R Kelly, Use of a Keratin-Based Wound Dressing in the Management of Wounds in a Patient with Recessive Dystrophic Epidermolysis Bullosa, Adv Skin and Wound Care 2012;25:400-3. http://www.ncbi.nlm.nih.gov/pubmed/22914035
- P M Pechter, J Gil, J Valdes, M Tomic-Canic, I Pastar, O Stojadinovic, R S Kirsner and S C Davis. Keratin dressings speed epithelialization of deep partial-thickness wounds. Wound Repair and Regeneration, (2012) vol 20, pp 236-242. http://www.ncbi.nlm.nih.gov/pubmed/22332782
- L. Tang, J. Ollague Sierra, R. Kelly, R. S. Kirsner, J. Li, Wool-derived keratin stimulates human keratinocyte migration and types IV and VII collagen expression, Experimental Dermatology, 21, 5, 2012, DOI: 10.1111/j.1600-0625.2012.01505.x http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0625.2012.01505.x/pdf
- M Than, R Smith, S Cassidy, R Kirsner, R Kelly, C Marsh, A Maderal, Use of Keragel in the Management of Recessive Dystrophic Epidermolysis Bullosa. Journal of Dermatological Treatment, epub 21 jan 2012. http://www.ncbi.nlm.nih.gov/pubmed/22208480
- C Hammond, M Than, J Walker. From the laboratory to the leg: Patient's and nurses perceptions of product application using three different dressing formats, Wound Practice and Research, 18, 4, 189-195, November 2010. http://www.awma.com.au/journal/1804_05.pdf
- R Kirsner Use of topical keratin gel by patients with epidermolysis bullosa, Journal of the American Academy of Dermatology, March 2009 (Vol. 60, Issue 3, Supplement 1, Page AB202)
- S Davis, R Perez, Y Rivas, J Gil, J Valdes, and R Kirsner, The effect of a keratin based dressing on the epithelialization of deep partial thickness wounds, Journal of the American Academy of Dermatology March 2009 (Vol. 60, Issue 3, Supplement 1, Page AB201)
Conference Presentations and Posters
- G Tadini, C Marsh, R Kirsner, An evaluation of a keratin gel to accelerate healing and improve care for dystrophic epidermolysis bullosa patients, SAWC San Antonio, Texas, April 2015 and EWMA, London, May 2015.
- I Kolossa, C Marsh, R Kirsner, R A Smith, A clinical trial of a keratin gel to accelerate healing and improve comfort post haemorrhoidectomy, SAWC San Antonio, Texas, April 2015 and EWMA, London, May 2015.
- J Denyer, C Marsh, R Kirsner, Keratin dressings in the management of epidermolysis bullosa SAWC San Antonio, Texas, April 2015 and EWMA, London, May 2015.
- M Belci, T Simone, R Singhal, L Stephen, C Marsh, Effectiveness of topical therapies based on keratin for pressure sore in spinal cord injury, SAWC San Antonio, Texas, April 2015 and EWMA, London, May 2015.
- J Jutkiewicz-Sypniewska, M Plewko, C Marsh, Novel use of a keratin gel to epithelise areas with delayed healing as part of a procedure for giant nevus. SAWC San Antonio, Texas, April 2015 and EWMA, London, May 2015.
- T Simone, L Salman, B Maurizio, C Foti Effectiveness Of Topical Therapies Based On Keratin For Pressure Sores In Spinal Cord Injury, A Preliminary Study, National Congress of SOMIPAR, Bergamo, Italy, May 2014.
- C Marsh, R Kelly, RA Smith, R Kirsner Keratin-based wound products– providing a cytokine-like input to improve wound healing? Proceedings of EWMA Conference, Madrid 2014.
- F Loan, C Marsh, S Cassidy, J Simcock, A case study series evaluation of a range of keratin-based dressings for partial thickness burns, Proceedings of EWMA Conference, Madrid 2014.
- J Denyer, Keratin Dressings in the Management of Epidermolysis Bullosa, Proceedings of EWMA Conference, Madrid 2014.
- J Denyer, C Marsh, R Kirsner Use of a keratin gel in the management of Epidermolysis Bullosa, Proceedings of SAWC spring 2014, Orlando, Fl, April 2014.
- F Loan, C Marsh, S Cassidy, J Simcock, Keratin dressings for effective wound care management partial thickness burn injuries, Proceedings of SAWC, Orlando, Fl, April 2014.
- R J Snyder, M Moradi, C Marsh, R Kelly, A Case Study Series Showing Exceptional Healing on Hard to Heal Chronic Wounds with Keratin, Proceedings of SAWC spring 2014, Orlando, Fl, April 2014.
- J Denyer keragelT for management of Epidermolysis Bullosa, a case study series. EWMA 2013.
- S Cassidy, F Loan, J Simcock, C Marsh, Use of Functional Keratin on Superficial and Partial Thickness Burns, NZWCS May 2013.
- C Marsh Clinical evaluations of nz-developed, keratin-based wound healing products in innovative, early-adopter wound healing centres in usa, NZWCS May 2013.
- N Blasiole, E Mostow, Use of keratin gel technology to speed healing of hard to heal wounds. Proceedings of SAWC, Denver, CO, May 2013.
- T Treadwell, D Walker, B J Nicholson, M Taylor, The Use of Keratin Dressings in the Treatment of Venous Ulcers, Proceedings of SAWC, Denver, CO, May 2013.
- F Loan, C Marsh, S Cassidy, J Simcock, Keratin dressings for effective wound care management in acute superficial and partial thickness burn injuries, Proceedings of SAWC, Denver, CO, May 2013.
- V Capasso, Keratin Products in the Treatment of an Unusual Acute Surgical Wound with Tendon Exposure, Proceedings of SAWC, Denver, CO, May 2013.
- F Wahid, B A Shrunjay, R Patel, S Wu, A new approach to diabetic foot ulcers using keratin gel technology, Proceedings of SAWC, Denver, CO, May 2013.
- W Q Fu, et al, A Randomised Controlled Trial of Functional Keratin Dressings for Treatment of Chronic Venous Leg Ulcers, Proceedings of SAWC, Denver, CO, May 2013.
- A Batzer, Maximising Healing Outcomes with Keratin Based Wound Products, Proceedings of SAWC, Atlanta, GA, April 2012
- R Kelly, C Marsh, J Li, R Smith, R Kirsner The Impact of Keratin Protein on Keratinocyte Cell Growth and the Implications for Keratin Based Wound Treatments, Proceedings of SAWC, Atlanta, GA, April 2012Th
- J Redmond, E Milner, C Marsh, A case study series using keratin based technology for skin tears, Proceedings of SAWC 2012, Atlanta, GA, April 2012.
- A Davidson, J Simcock, H Jina C. Marsh, A pilot study of a keratin product in skin graft donor site epithelisation, Proceedings of SAWC 2012, Atlanta, GA, April 2012.
- J Redmond, E Milner, M Dutton and C Marsh, A Case Study Series Using Keratin Based Dressings For Skin Tears, proceeding of AWMA conference, Sydney, Aus, Mar 2012.
- R Smith, R Kirsner, R Kelly, C Marsh, J Li, The Science of keratin protein: a new paradigm in wound healing, proceedings of AWMA conference, Sydney, Aus, Mar 2012.
- A Davidson , J Simcock, H Jina and C Marsh , A Pilot Study Of Keratin Dressings In Skin Graft Donor Site Epithelialisation, proceeding of NZWCC conference, Dunedin, NZ, Nov 2011.
- H Jina, J Simcock, M Than, S Cassidy and C Marsh The effect of using a keratin bases gel on median sternotomy scarring, proceedings of Plastic Surgery Congress, July 2011, Gold Coast, Australia
- A Arbuckle, A case study series of the management of Epidermolysis Bullosa using Keragel T, Society of Paediatric Dermatology Portland USA, July 10
- R Kelly, C Marsh, M Than, S Cassidy, RA Smith, Topical keratin for improvement of skin and wound healing, New Zealand dermatology society conference, May 10
- Management of recessive dystrophic epidermolysis bullosa using keragelT, DEBRA patient care conference, Cincinnati USA, April 10.
- Management of epidermolysis bullosa simplex using keragelT, DEBRA patient care conference, Cincinnati USA, April 10
- M Than, C Hammond, R A. Smith, C Marsh, R Kelly, P Rohricht, R S Kirsner, A Prospective Pilot Study of Keratin Dressings: Effectiveness on Refractory (Large and of Long Duration) Venous Leg Ulcers SAWC, April 2010, Orlando, Florida.
- R Perez, R Kirsner, J Gil, J Valdes, S Davis, Evaluation of the effects of two keratin formulations on wound healing and keratin gene expression in a porcine model, Symposium on Advanced Wound Care conference presentation, April 2009.
- W Thompson, S Hanneke, M Compton, L Burrage, K Butler, A keratin matrix interface in negative pressure wound therapy, Clinical Symposium on Advances in Skin and Wound Care, Las Vegas Oct 26-30, 2008.
- S Cassidy, M Than, Improved healing of Epidermolysis Bullosa wounds using a novel keratin gel technology, Australian Wound Management Association conference proceedings, May 2008.
- J Randles, The use of a keratin dressing on a recalcitrant venous leg ulcer, Australian Wound Management Association conference proceedings, May 2008.
- K Balance, C Marsh, M Than, Improved healing of a diabetic foot ulcer using new keratin dressing technology, Australian Wound Management Association conference proceedings, May 2008.
- R Kelly, F Sigurjonsson, R A Smith, A Ali, M Than, R Mcpherson, C Hammond, Keratin biopolymer dressings for wound care, Symposium on Advanced Wound Care conference proceedings, 2006.