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

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.

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.