Use of vacuum-assisted closure and a dermal regeneration

Am J. Orthop. · Jun 2009

Use of vacuum-assisted closure and a dermal regeneration template as an alternative to flap reconstruction in pediatric grade IIIB open lower-extremity injuries.

Severe degloving injuries to the pediatric lower extremity are difficult to treat, traditionally requiring local or free flaps for coverage. Combining vacuum-assisted closure techniques with a dermal regeneration template is proposed as a means for covering these difficult wounds. We retrospectively reviewed the charts of 7 consecutive patients (age range, 2-12 years) who underwent this treatment. ⋯ Mean follow-up was 24.4 months, and mean wound size was 196 cm2. There were 2 superficial graft complications, 1 nonunion successfully treated with bone grafting, 2 patients with subsequent bony deformity, and 1 patient who underwent subsequent soft-tissue procedures for equinus contracture. Use of vacuum-assisted closure and a dermal regeneration template has shown good results as a means of successfully managing grade IIIB injuries without performing complicated flap reconstructions.

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- Ted M Barnett and Jeffrey S Shilt.
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1070, USA. tbarnett@wfubmc.edu
- Am J. Orthop. 2009 Jun 1;38(6):301-5.
AbstractSevere degloving injuries to the pediatric lower extremity are difficult to treat, traditionally requiring local or free flaps for coverage. Combining vacuum-assisted closure techniques with a dermal regeneration template is proposed as a means for covering these difficult wounds. We retrospectively reviewed the charts of 7 consecutive patients (age range, 2-12 years) who underwent this treatment. All extremities healed without flap reconstruction or amputation. Mean follow-up was 24.4 months, and mean wound size was 196 cm2. There were 2 superficial graft complications, 1 nonunion successfully treated with bone grafting, 2 patients with subsequent bony deformity, and 1 patient who underwent subsequent soft-tissue procedures for equinus contracture. Use of vacuum-assisted closure and a dermal regeneration template has shown good results as a means of successfully managing grade IIIB injuries without performing complicated flap reconstructions.

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Use of vacuum-assisted closure and a dermal regeneration template as an alternative to flap reconstruction in pediatric grade IIIB open lower-extremity injuries.

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