{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:04:02Z","timestamp":1789473842258,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T00:00:00Z","timestamp":1409702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pressure ulcers present a major clinical challenge, are physically debilitating and place the patient at risk of serious comorbidities such as septic shock. Recombinant human activated protein C (<jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content>) is an anticoagulant with anti\u2010inflammatory, cytoprotective and angiogenic effects that promote rapid wound healing. Topical negative pressure wound therapy (<jats:styled-content style=\"fixed-case\">TNP<\/jats:styled-content>) has become widely used as a treatment modality in wounds although its efficacy has not been proven through randomised controlled trials. The aim of this study was to determine the preliminary efficacy and safety of treatment with <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> for severe chronic pressure sores with and without <jats:styled-content style=\"fixed-case\">TNP<\/jats:styled-content>. This case presentation describes the history, management and outcome of two patients each with a severe chronic non\u2010healing pressure ulcer that had failed to respond to conventional therapy. <jats:styled-content style=\"fixed-case\">TNP<\/jats:styled-content> was added to conservative management of both ulcers with no improvement seen. Then local application of small doses of <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> was added to <jats:styled-content style=\"fixed-case\">TNP<\/jats:styled-content> and with conservative management, resulted in significant clinical improvement and rapid healing of both ulcers, displaying rapid growth of vascular granulation tissue with subsequent epithelialisation. Patients tolerated the treatment well and improvements suggested by long\u2010term follow\u2010up were provided. Randomised placebo\u2010controlled double blind trials are needed to quantify the efficacy, safety, cost\u2010effectiveness, optimal dose and quality of life changes seen from treatment with <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/iwj.12343","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T09:47:38Z","timestamp":1409737658000},"page":"986-991","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Activated protein C to heal pressure ulcers"],"prefix":"10.1111","volume":"13","author":[{"given":"Aruna","family":"Wijewardena","sequence":"first","affiliation":[{"name":"Department of Burns and Plastic and Reconstructive Surgery Royal North Shore Hospital  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepehr S","family":"Lajevardi","sequence":"additional","affiliation":[{"name":"Department of 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