(CS-097) Open Midfoot Fracture/Dislocation Wound Healed with a Fish Skin Graft

Peter Lovato, DPM; Rimi Statkus, DPM; Kimberly Nolan, DPM

Introduction: Open fractures with critical soft tissue disruption can cause difficulty in healing an injury and puts a patient at higher risk of amputation.  Treating open fractures is difficult because the patient is at a higher risk of infection and may require multiple operations. The ability to cover lost soft tissue increases the success rate of reconstruction. Different treatment modalities of closing the soft tissue defect include skin grafting, muscle and free flap reconstruction, and negative pressure wound vac therapy.

Methods: A 30 year old female presented to the emergency room following a car accident with an open lisfranc injury. The injury was reduced and pinned. An application of a skin substitute was applied 3 days later for  the open wound that was 39 sq cm. A second skin graft substitue was applied 11 weeks later for a total surface around of 21 sq cm. 

Results: The patient was able to heal the wound after two applications of fish skin substitute over the period of about 3 months. This allowed for the patient to successful heal her fracture without any complications.

Discussion: Injuries with a critical soft tissue defect increases a patient's risk of amputation and further complications. Fish skin substitute is a treatment modality to achieve soft tissue coverage, which increases the chances of the patient successfully recovering from the injury.