<< Back to the abstract archive
Reconstruction of a Large Volume Wound with Integra Primatrix: A Case Report
Kelsey Isbester, BS, Corinne Wee, MD, Joseph Khouri, MD
University Hospital Cleveland Medical Center
2019-01-30
Presenter: Kelsey Isbester
Affidavit:
The majority of this project represents the original work of the resident.
Director Name: Kelsey Isbester
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
Increasing innovation in regenerative technologies offers new solutions to wounds that would have previously required flap reconstruction. These regenerative templates form the basis of the "hybrid reconstructive ladder" and are especially useful in poor surgical candidates as they can convert long, extensive surgeries into shorter, less demanding surgeries. Herein we describe our surgical approach to a patient who suffered extensive soft tissue loss.
Methods:
This is a case report of a 61-year-old female who sustained multiple injuries after she was smashed between a wall and a motor vehicle. She developed a large left flank hematoma with resultant flank necrosis. Due to baseline comorbidities and multiple associated injuries, she was an extremely poor surgical candidate. After serial debridements, the final wound size was 990cm2 and 7cm deep. Two layers of Integra PriMatrix were layered to reconstruct the volume deficit. Significant wound shrinkage and granulation tissue was noted six days post-operatively; wound area at this time was 475cm2. Six weeks later, she underwent a split-thickness skin graft. Three weeks after grafting, she was noted to have 80% take of her graft without any signs of infection.
Conclusion:
Layering of regenerative templates can fill large volume defects in patients who are poor candidates for flap reconstruction. Use of regenerative technology prevents a longer, complex operation and spares the patient of donor site morbidity. This is especially important in complicated patients where complex surgeries may significantly halt rehabilitation progress.
