Biodegradable Temporizing Matrix Reconstruction of Complex Perineal Burn Wound: A Case Report
Autor: | Patrick Coghlan, John E. Greenwood, Nicholas S. Solanki, Lindsay DamKat Thomas, Elizabeth Concannon |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty Soft Tissue Injuries medicine.medical_treatment Thigh Perineum 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine medicine Humans Frail elderly Buttocks Aged Wound Healing Debridement Burn wound business.industry Graft Survival Rehabilitation 030208 emergency & critical care medicine Skin Transplantation Anus Surgery medicine.anatomical_structure Urethra Emergency Medicine Contracture medicine.symptom Burns business |
Zdroj: | Journal of Burn Care & Research. 42:1038-1042 |
ISSN: | 1559-0488 1559-047X |
Popis: | This case report details our experience using a two-stage Biodegradable Temporizing Matrix (NovoSorb® PolyNovo Ltd) and autograft for acute reconstruction of a complex perineal burn wound in an elderly comorbid patient. A 77-year-old man sustained 42% full-thickness burns extending circumferentially from bilateral thighs and buttocks, across the entire perineal and genital regions up to his mid-trunk, following self-immolation using an accelerant. Early total burn wound excision was carried out with acute application of Biodegradable Temporizing Matrix to all affected sites. Excellent integration and vascularization of Biodegradable Temporizing Matrix took place despite the challenge of intermittent fecal contamination affecting the perineal and buttock burn sites and matrix colonization with multidrug-resistant organisms. Delamination and serial split-thickness skin autografting were carried out 42 days after the first matrix application with complete and robust graft take. Perineal burns present a reconstructive challenge due to the proximity of specialized structures such as the genitalia, urethral, and anal orifices. Restoration of complex anatomy and function may be required after debridement with increased risks of infection, contracture formation, and mortality compared with burns affecting other anatomical sites. Two-stage Biodegradable Temporizing Matrix represents a reliable reconstruction option for complex extensive perineal wounds in frail elderly patients, despite an unfavorable local microbial environment. |
Databáze: | OpenAIRE |
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