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Product Description and Benefits
  Indications for Use
  Product Makeup/Histology
  Clinical Sequence
 
    Venous Stasis Ulceration
    Ulceration to both feet and anterior ankles
    Trans-metatarsal amputation
    Traumatic degloving calcaneal fracture
 
    Achilles Ulcer
    Exposed Bone
    Chronic Venous Ulceration
    Immunopathic Wound
    Exposed Joint
    Limb Salvage
    Leg Ulceration
    Arterial Disease
    Hypercoagulable Disorder
    Ankle Ulcer
    Ischemic Ulceration
    Forefoot Ulceration
    Heel Ulcer
    Summary
  Summary
   


Stump Salvage
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A 53-year-old man had below knee amputation for diabetic vascular complications. Most surgeons seeing a stump complication indiscriminately do an above knee amputation, most of which are unnecessary. This wound had granulation tissue and other wound module elements indicative of sufficient circulation and competence to heal. Necrosis was a consequence of avoidable technical factors. With patience, good wound care, and suitable surgery, this below knee amputation can be preserved and healed.

Electrical/flame burn to neck


After a period of debridement and good daily care, the wound met criteria for reclosure. Note the exposed necrotic tibial surface, which needed excision.

Fascial excision of chest

In surgery, the prepared wound was excised and anterior tibia was decorticated. For closure, the conventional choices of grafts and flaps were either not available or not likely to work. Had they been the only choices, higher amputation might have been considered. However, Integra solved this problem with no risk to the stump or to the patient. Integra is not an alternative nor substitute for classic surgery, but rather an independent surgical modality that works where conventional methods cannot.

INTEGRA® Dermal Regeneration Template

The stump healed. Throughout the reconstruction, a rigid posterior platform splint maintained an extended knee, permitting expeditious rehabilitation. This image is three months after skin grafts. The patient had fallen, causing a tangential avulsion laceration of the newly healed epidermis. Treated and re-healed like any similar laceration. This minor traumatic injury illustrates that the Integra wound requires some time to develop sufficient strength to bear the requirements of daily life. Appropriate caution and care should be taken for several months after reconstruction.

Elastic net dressing

Cases Courtesy of:
Marc E. Gottlieb, M.D., Jennifer Furman
Journal of Burns and Wounds, Vol 3, #2

 
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