Microcluster colloidosomes for hemostat delivery into complex wounds: A platform inspired by the attack action of torpedoes

Management of complex wounds with large skin defects presents a real challenge for orthopedic or reconstructive surgeons. We developed a simple skin stretching system associated with vacuum sealing drainage to examine the efficiency and complication. A total of 34 patients with different types of complex wounds were retrospectively included from January 2015 to March 2021. All patients in the study were underwent the treatment by 2 stages. The method was used to the wounds from 4.71 to 169.65 cm2 with a median defect size of 25.13 cm2. The median time for wound closure was 11.5 days (range: 5-32 days), although the median absolute reduction was 2.08 cm2/day (range: 0.15-25.66 cm2/day). Depending on the site of the wounds, the cause of the wound, and the rate of max-width/max-length ( W/ L), these complex wounds could be separately divided into several groups. There were statistically significant differences in the median value of the above variables ( P < .05 Kruskal–Wallis test). The results showed that different anatomical sites had different viscoelastic properties, the complex wounds caused by trauma were easier to close than caused by diabetic foot and the complex wounds in group A ( W/ L ＞ 0.5) were more difficult to close than in group B ( W/ L ≤ 0.5). No major complications were encountered in this study. In summary, the results of our study showed that the simple skin stretching system associated with vacuum sealing drainage was a safe approach for closure of complex wounds. Nevertheless, more attention should be paid to the viscoelasticity of the wounds to ensure closure and avoid undue complications when applying the method.

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Experience with NovoSorb ® Biodegradable Temporising Matrix in reconstruction of complex wounds

ANZ Journal of Surgery ◽

10.1111/ans.16936 ◽

2021 ◽

Author(s):

Henry Li ◽

Pelicia Lim ◽

Edward Stanley ◽

Geoffrey Lee ◽

Sandra Lin ◽

...

Keyword(s):

Complex Wounds

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Wound-Management of Complex Wounds

Journal of Wound Ostomy and Continence Nursing ◽

10.1097/01.won.0000351990.74790.2f ◽

2009 ◽

Vol 36 (Supplement) ◽

pp. S35-S36

Author(s):

James B. Lutz ◽

Joy E. Schank

Keyword(s):

Wound Management ◽

Complex Wounds

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Wound-Management of Complex Wounds

Journal of Wound Ostomy and Continence Nursing ◽

10.1097/01.won.0000352071.83651.b4 ◽

2009 ◽

Vol 36 (Supplement) ◽

pp. S61-S62 ◽

Cited By ~ 1

Author(s):

Takkin Lo ◽

Patrick Moore ◽

Nancy Cortes Delamora ◽

Noha Daher

Keyword(s):

Wound Management ◽

Complex Wounds

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Use of a human acellular dermal wound matrix in patients with complex wounds and comorbidities

Journal of Wound Care ◽

10.12968/jowc.2015.24.6.261 ◽

2015 ◽

Vol 24 (6) ◽

pp. 261-267 ◽

Cited By ~ 6

Author(s):

M.L. Williams ◽

J.E. Holewinski

Keyword(s):

Wound Matrix ◽

Acellular Dermal ◽

Complex Wounds ◽

Dermal Wound

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659 Non-Burn Etiologies Treated with Autologous Skin Cell Suspension: A Case Series Demonstrating the Efficacy in Complex Wounds

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.324 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S195-S195

Author(s):

Nicole M Kopari ◽

Yazen Qumsiyeh

Keyword(s):

Soft Tissue ◽

Cell Suspension ◽

Negative Pressure ◽

Wound Closure ◽

Negative Pressure Wound Therapy ◽

Case Series ◽

Dermal Substitute ◽

Wound Therapy ◽

Skin Cell ◽

Complex Wounds

Abstract Introduction Complex wounds (CW) resulting from necrotizing soft tissue infections (NSTIs) and soft tissue traumatic injuries create unique challenges. Radical debridement is often the first step in management but can result in disfigurement with impaired function and compromised cosmesis. The standard of care at our institution for full-thickness burn injuries of similar complexity is widely meshed autografting with application of autologous skin cell suspension (ASCS). Our study is a case series reviewing outcomes using ASCS for CW from non-burn etiology. Methods A retrospective chart review from March 2019 through July 2020 was performed to evaluate the effectiveness of ASCS and widely meshed autografting in CW. Patients presenting with CW underwent serial excisions of devitalized tissue by acute care and burn surgeons. Dermal substitute utilization for wound preparation was at the discretion of the surgeon. Definitive wound closure was achieved using ASCS in combination with a widely meshed autograft. The wounds were covered with a non-adherent, non-absorbent, small pore primary dressing along with bismuth-impregnated, petroleum-based gauze or negative pressure wound therapy dependent on wound bed contour. Further padding with gauze was applied along with compressive dressing. Results In total, 8 patients with CW were included in this review. The mean age was 58 years (range 27-85) with an equal number of males and females. Wound etiology included NSTI (n=5), degloving injury (n=2), and traumatic amputation (n=1). The average wound size measured 1,300cm2 (range 300-3,000). 50% of the patients were treated with a dermal substitute and negative pressure wound therapy prior to ASCS and autograft placement. 7 of 8 patients received split-thickness skin grafting in the ratio of 3:1 with one patient grafted at a 2:1 expansion. 7 of the 8 patients had >90% wound closure within 8-10 days of ASCS and autograft application. One patient had significant graft failure after removing surgical dressings and autograft in the early post-operative period secondary to dementia. One patient expired during the follow-up period secondary to medical comorbidities. The 6 remaining patients had durable wound closure and acceptable cosmetic outcome. All patients were discharged within 10 days of ASCS application with 4 patients discharging home and 4 patients discharging to an acute inpatient rehabilitation. Conclusions This study is the first case series to review ASCS in combination with widely meshed skin grafts in the management of CW from a non-burn etiology. Durable, timely wound closure and an acceptable cosmetic outcome was achieved in these often-challenging CW.

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Acellular fish skin grafts for the management of wounds in dogs and cats: 17 cases (2019–2021)

American Journal of Veterinary Research ◽

10.2460/ajvr.21.09.0140 ◽

2021 ◽

pp. 1-5

Author(s):

Elise S. Mauer ◽

Elizabeth A. Maxwell ◽

Christina J. Cocca ◽

Justin Ganjei ◽

Daniel Spector

Keyword(s):

Soft Tissue ◽

Clinical Outcomes ◽

Medical Records ◽

Complete Healing ◽

Wound Management ◽

Skin Grafts ◽

Fish Skin ◽

Secondary Intention ◽

Management Techniques ◽

Complex Wounds

Abstract OBJECTIVE To report the clinical outcomes of the use of acellular fish skin grafts (FSGs) for the management of complex soft tissue wounds of various etiologies in dogs and cats. ANIMALS 13 dogs and 4 cats with complex wounds treated with FSGs between February 2019 and March 2021. PROCEDURES Medical records were reviewed for information regarding cause, location, size of the wound, management techniques, complications, and clinical outcomes. RESULTS In dogs, the number of FSG applications ranged from 1 to 4 (median, 2 graft applications). The time between each application ranged from 4 to 21 days (median, 9.5 days). Time to application of the first FSG ranged from 9 to 210 days (median, 19 days). Wounds closed by second-intention healing following the first fish skin application between 26 and 145 days (median, 71 days; n = 12). In cats, 1 or 2 FSGs were used, and the wounds of 3 of 4 cats healed completely by secondary intention. The wounds of 1 dog and 1 cat did not heal. There were no adverse events attributed to the use of the FSGs. CLINICAL RELEVANCE For dogs and cats of the present study, complete healing of most wounds occurred with the use of FSGs, the application of which did not require special training, instruments, or bandage materials.

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