Treatment of chronic heel osteomyelitis in vasculopathic patients. Can the combined use of Integra^®, skin graft and negative pressure wound therapy be considered a valid therapeutic approach after partial tangential calcanectomy?

Abstract

Osteomyelitis of the calcaneus is a difficult problem to manage. Patients affected by osteomyelitis of the calcaneus often have a below-the-knee amputation because of their comorbidity. In this article, we present seven cases of heel ulcerations with chronic osteomyelitis treated with Integra(®) Dermal Regeneration Template, skin graft and negative pressure wound therapy after partial tangential calcanectomy, discussing the surgical and functional results. In this casuistic of patients, all wounds healed after skin grating of the neodermis generated by Integra(®), with no patient requiring a below-knee amputation.

Management of chronic osteomyelitis of the tibia with life‐threatening complications under negative pressure wound therapy and isolation of Helcococcus kunzii

“…It appears possible that all the individual factors added up and resulted in the mentioned complication. Nevertheless, negative pressure dressing therapy for temporarily covering a wound is an established treatment in the field of reconstructive plastic surgery . Complications such as an erosion of a nearby artery in an infected wound are rare but need to be considered as a possible outcome .…”

An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft

“…Every study assessed that, thanks to the integrated use of these techniques, the preparation of the wound bed was quicker in order to obtain a better graft take [14]. In fact NPWT used over the dermal template delivered a faster maturation (approximately 1-2 weeks) and a higher integration quality [15, 16]. This integrated technique keeps the matrix immobilized, leaves the wound bed moist and free of debris, prevents the accumulation of fluid collections, and reduces bacterial colonization of the wound [13].…”

Successful salvage and reconstruction of a finger threatened by Vibrio vulnificus necrotising fasciitis using fenestrated‐type artificial dermis and three steps of topical negative pressure wound therapy

“…A previous report by Baldwin et al reported that combination therapy with artificial dermis and NPWT in vitro benefits from continuous negative pressure‐mediated stimulation of the migration and proliferation of human microvascular endothelial cells cultured on the surface of the artificial dermis through the fenestrae of the silicone layer . In clinical cases, Fraccalvieri et al reported that NPWT accelerated dermis‐like tissue formation and produced a good rate of incorporation of mesh skin graft . Finally, the autologous STSG supplemented with NPWT was applied to cover the well‐grown artificial dermis (Figure ; NPWT step 3).…”