“Elephant-trunk” negative pressure wound therapy for fixing artificial dermis with basic fibroblast growth factor for critical limb ischemia

Niimi, Yosuke; Nakamoto, Kan; Kamei, Wataru; Osa, Nagisa; Hori, Keijiro; Sakurai, Hiroyuki

doi:10.1016/j.reth.2021.08.002

Cited by 3 publications

(1 citation statement)

References 22 publications

(25 reference statements)

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“…This patient had undergone flap reconstruction twice, but both had failed; NPWT proved to be an efficient technique to cover a wide area of exposed tibial bone in a patient who was not a candidate for free-flap surgery 2) . NPWT combined with bFGF and artificial dermis is reportedly effective for treating intractable toe ulcers with critical limb ischemia 15) . These combinations are expected to be effective and minimally invasive treatments for bone-exposed wounds.…”

Section: Discussionmentioning

confidence: 99%

Skin Grafting on Wound with Exposed Bone

Fujioka

Fukui

Yoshino

et al. 2023

International Journal of Surgical Wound Care

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Introduction: In general, exposed bone wounds are covered with flaps. If the wound is small, skin grafting with perifascial areolar tissue can be performed for resurfacing; however, it is not suitable for large bone-exposed wounds exceeding 5 cm in length. Methods: Six patients underwent skin grafting for bone-exposed wounds at our medical center between 2014 and 2020. In all cases, a suitable local flap donor site could not be found around the wound, and a suitable donor vessel to anastomose the free flap was difficult to find. After a sequestrectomy, slit artificial dermis was applied to the wounds, and basic fibroblast growth factor was sprayed. Ointment-impregnated gauze was applied to the wounds. After confirming the creation of a suitable wound bed, skin grafting was performed. Results: In all cases, after skin grafting, the exposed bone wounds were closed. Four cases were due to extensive burns, one was due to malignant tumor resection, and one was due to exposed bone after injury. For burn injuries, suitable skin flap donors were difficult to find. Three cases of bone exposure involved the skull, and the rest involved the anterior surface of the tibia. Four cases required split-thickness skin grafts (including two mesh skin grafts), and two required full-thickness skin grafts. Covering a wound after skin grafting took 3 weeks to 3 months (median, 1 month), which is much longer than the time taken when using a skin flap. Conclusion: Even for exposed bone wounds with poor blood circulation, a good wound bed can be created by the combination of artificial dermis and bFGF, and wound closure can be achieved by skin grafting. Bone-exposed wounds should be closed early using a skin flap. However, when the patient's general condition is poor or when temporary closure is difficult due to the unavailability of a suitable donor, wound closure by skin grafting is a simple and useful treatment option, although it takes a long time.

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Section: Discussionmentioning

confidence: 99%

Skin Grafting on Wound with Exposed Bone

Fujioka

Fukui

Yoshino

et al. 2023

International Journal of Surgical Wound Care

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Basic fibroblast growth factor combined with extracellular matrix-inspired mimetic systems for effective skin regeneration and wound healing

Bian

Song

2023

Materials Today Communications

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The dose-effect regularity of artificial dermis combined with growth factor in repair wound of luxation of the bone tendon

et al. 2023

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To investigate the treatment efficacy of the artificial dermis combined with growth factor surgery in patients with luxation of bone tendon (LBT). A total of 40 patients with LBT in our prospective clinical research are randomly allocated to following four groups: Control, low dose, medium dose, and high dose. The baseline characteristics, skin graft interval time, overage rate of regenerated tissue at bone and tendon, and visual estimation of patients were measured, which were then utilized to assess the treatment efficacy of the artificial dermis combined with growth factor surgery in LBT patients. Our outcomes indicated that the artificial dermis combined with growth factor surgery showed significantly less skin graft interval time, higher overage rate of regenerated tissue at bone and tendon, less Vancouver scar scale score compared to those treated by conventional imaging technology (all P < 0.05). It concludes that the artificial dermis combined with growth factor surgery can improve the treatment efficacy, and the medium dose growth factor is a promise dose to treat the patients with LBT.

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“Elephant-trunk” negative pressure wound therapy for fixing artificial dermis with basic fibroblast growth factor for critical limb ischemia

Cited by 3 publications

References 22 publications

Skin Grafting on Wound with Exposed Bone

Skin Grafting on Wound with Exposed Bone

Basic fibroblast growth factor combined with extracellular matrix-inspired mimetic systems for effective skin regeneration and wound healing

The dose-effect regularity of artificial dermis combined with growth factor in repair wound of luxation of the bone tendon

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