Evaluation of dermagraft as an alternative to grafting for open fasciotomy wounds

Treatment of postoperative lower extremity wounds using human fibroblast-derived dermis: a retrospective analysis

Human fibroblast-derived dermis skin substitute is a well-studied treatment for diabetic foot ulcers; however, no case series currently exist for its use in healing postoperative wounds of the lower extremity. A retrospective analysis was conducted on 32 lower extremity postoperative wounds treated weekly with human fibroblast-derived dermis skin substitute. Postoperative wounds were defined as a wound resulting from an open partial foot amputation, surgical wound dehiscence, or nonhealing surgical wound of the lower extremity. Wound surface area was calculated at 4 and 12 weeks or until wound closure if prior to 12 weeks. Postoperative wounds treated with weekly applications showed mean improvement in surface area reduction of 63.6% at 4 weeks and 96.1% at 12 weeks. More than 56% of all wounds healed prior to the 12-week endpoint. Additionally, only one adverse event was noted in this group. This retrospective review supports the use of human fibroblast-derived dermis skin substitute in the treatment of postoperative lower extremity wounds. This advanced wound care therapy aids in decreased total healing time and increased rate of healing for not only diabetic foot wounds but also postoperative wounds of the lower extremity, as demonstrated by this retrospective review.

Active wound coverings: bioengineered skin and dermal substitutes

Extensive skin loss and chronic wounds present a significant challenge to the clinician. With increased understanding of wound healing, cell biology, and cell culture techniques, various synthetic dressings and bioengineered skin substitutes have been developed. These materials can protect the wound, increase healing, provide overall wound coverage, and improve patient care. The ideal skin substitute may soon become a reality.

Closing fasciotomy wounds using plastic bands: an alternative simple and cheap method

Fasciotomy incisions are essential to relieve pressure on the neurovascular structures in the limbs. However, closing such wounds often becomes a challenge to the surgeon. The aim of this study is to describe a simple and cheap method of closing these wounds. Plastic bands were used to gradually close fasciotomy wounds in five patients. All fasciotomy wounds in the five patients closed successfully within 4-12 days. Only two patients developed minimal complications in the form of minor wound infection and a hypertrophic scar. We conclude that the plastic band method used here is cheaper and simpler in comparison to similar techniques using the same device.

Use of a living dermal equivalent for a refractory abdominal defect after pediatric multivisceral transplantation

BACKGROUND

Primary closure is not always possible after pediatric multivisceral transplantation. Reepithelialization may require extended periods of postoperative time, which can be associated with significant morbidity.

OBJECTIVE

The objective was to accelerate secondary wound closure thereby minimizing infection or further complications in a pediatric multivisceral transplant patient.

METHODS

Five applications of human fibroblast-derived dermis (Dermagraft, Smith and Nephew) were applied to the postsurgical defect of a pediatric multivisceral transplant patient over the course of 8 months. Routine wound care and observation was performed between human fibroblast-derived dermis applications.

RESULTS

Human fibroblast-derived dermis stimulated healing and accelerated reepithelialization. Signs of clinical rejection or infection were not observed.

CONCLUSION

Reepithelialization can be aided in the postoperative period in pediatric multivisceral transplant patients with human fibroblast-derived dermis, thereby helping to deter complications associated with secondary wound closure. We have illustrated the successful use of a human fibroblast-derived dermis as an adjunct for wound healing in a complicated surgical defect.