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Combination of negative pressure wound therapy (NPWT) and integra dermal regeneration template (IDRT) in the lower extremity wound; Our experience with 4 cases

The treatment of de-gloving injuries in the lower limb with exposed tendons, bone, and/or nerve is a challenging reconstruction problem. The standard management of de-gloving injuries involve either direct closure if the skin is viable or immediate grafting with the avulsed skin or full- or split-th...

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Detalles Bibliográficos
Autores principales: Attia, Attia, Elmenoufy, Tarek, Atta, Tarek, Harfoush, Ahmed, Tarek, Sayed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170806/
https://www.ncbi.nlm.nih.gov/pubmed/32322648
http://dx.doi.org/10.1016/j.jpra.2020.03.004
Descripción
Sumario:The treatment of de-gloving injuries in the lower limb with exposed tendons, bone, and/or nerve is a challenging reconstruction problem. The standard management of de-gloving injuries involve either direct closure if the skin is viable or immediate grafting with the avulsed skin or full- or split-thickness graft when the skin flap is not viable. Alternative methods are flap coverage especially when the underlying structures are not suitable for grafting such as extensive loss of paratenon and/or exposed bone or open joints The use of negative pressure wound therapy (NPWT) followed by use of Integra dermal regeneration template (IDRT) and subsequent split-thickness skin grafting (STSG) as an alternative to the previously mentioned surgical options has been described. In this series we describe the successful management of four patients with exposed tendons, bones, and joints of the distal lower extremity following road traffic accidents (RTA) using NPWT, Integra and thin split-thickness skin grafts.