(WHS-P101) ASSOCIATION OF NOVEL THERAPIES FOR COMPLEX CHRONIC WOUNDS.
Friday, May 17, 2024
7:30 AM – 5:00 PM East Coast USA Time
Background: Chronic wounds are those present for more than 4 weeks failing to produce anatomical and functional skin integrity being predominantly a condition of old individuals are with chronic illness. We also face challenges in aesthetic surgery. Methods and
Results: 4 chronic complex wound showing the association of new technologies to accelerate the healing process. Case 1: 65 years old (yo) woman ,30 days after an abdominoplasty and liposuction with the use of Renuvion®, septic, anemic and with 25% of a third-degree burn surface area. We started slowly because of the bad patient’s conditions, using the Cleanse Choice therapyTM for 3 times, every 48 hours. After that we finished to debride all the areas and started closing with local flaps or use dermal matrix (Nevelia®) and V.A.C.® therapy. After the skin grafts, there were a few graft losses. We used extracellular matrix from sheep fore-stomach (Endoform®), alginate plus silver (Silvercel®) and Mepilex Border®. After 5 weeks we discharged the patient, feeling well and with her self-esteem back. Case 2: 43 yo man, type II diabetes, dialytic with recurrence of a lesion at his right foot already partially amputated. At the first procedure we reduced the ulcer at a minimum size, after full debridement and local flaps we filled all empty spaces with Endoform® and used V.A.C. After one week, full granulation, were able to graft. After 3 weeks total, the graft became full integrated and the patient was back to his job. Case 3: 65 yo old woman with a donor site infected with a multiresistant germ. After the debridement we used Endoform® with antimicrobial, Silvercel® and Mepilex Border®. The patient also received systemic antibiotics. After 3 weeks the wound was totally closed. Case 4: a paraplegic 66 yo man with an ischiatic pressure sore, treated several times before by other teams, inclusive ours, 3 years ago, successfully. This year he appeared with a lesion similar to an excoriation. We found a huge seroma inside a fibrotic capsule and we made all the investigation to rule out osteomyelitis. After closing the wound with local muscle flaps, there was still slough at the edge of the skin. We covered it with Endoform® and Prevena Plus®. We obtained good results both at the incision and around it. After 3 weeks the patient got back to work.
Conclusion: after a correct diagnosis made by multidisciplinary team, we sometimes must gather novel technologies to give our patient as much comfort as possible, discharge faster and be able to make the follow up on an ambulatory basis, with the best cost benefit results, not only considering the money spent but also the quality of life to our patients.