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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
    Stump Salvage
    Achilles Ulcer
    Exposed Bone
    Chronic Venous Ulceration
    Immunopathic Wound
    Exposed Joint
    Limb Salvage
    Leg Ulceration
    Arterial Disease
 
    Ankle Ulcer
    Ischemic Ulceration
    Forefoot Ulceration
    Heel Ulcer
    Summary
  Summary
   


Hypercoagulable Disorder
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A 61-year-old woman had left leg ulceration of many years duration and a history of multiple venous thrombosis, pulmonary embolism, and warfarin resistance. These are hallmark features of a hypercoagulable disorder, but long standing warfarin therapy precluded making the exact pre-thrombotic diagnosis. In spite of the history, the usual stigmata of venous disease, pigment, edema, and dermatosclerosis, were not very severe, and there was never any improvement by compression and topical care alone. This was a hypercoagulable rather than a venous ulcer, further confirmed histologically by microthrombi. Granulation tissue at the base of the wound indicated intrinsic wound healing competence, but there was chronic active dermatitis, panniculitis, and necrosis in the margins and periwound soft tissues.

Electrical/flame burn to neck


After a few weeks of hygiene, good topical care, compression, and increased warfarin, the wound and periwound were improved, but nevertheless, inflammation and active necrosis-ulceration persisted at the margins.

Fascial excision of chest

In surgery, the ulcer was excised, including a tangential fibular ostectomy for hyperplastic osteophytes (common under chronic inflammatory ulcers, due to the effects of transforming or pro-proliferative growth factors which are perpetually in the wound). The wound was closed with Integra. Seen here at 6 days, periwound inflammation, erythema, and edema have completely subsided.

INTEGRA® Dermal Regeneration Template

The ulcer remained healed during a 4-year follow-up period, seen here 9 months after skin grafts.

INTEGRA® Dermal Regeneration Template

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

 
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