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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
    Hypercoagulable Disorder
 
    Ischemic Ulceration
    Forefoot Ulceration
    Heel Ulcer
    Summary
  Summary
   


Ankle Ulcer
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A 79-year-old woman presented with an ankle ulcer of several years duration. The right lateral malleolar area was inflamed with eczematous dermatitis. The wound base had granulation tissue indicative of sufficient arterial circulation and intrinsic wound healing competence. However, there was persistent active ulceration and failure of epithelial ingrowth. Workup for all of the usual culprits failed to make any diagnosis other than chronic pseudarthrosis at an old malleolar non-union directly under the ulcer. The significance of tissue mechanics and their influence on mesenchymal differentiation, repair, and pathology should never be overlooked. The cardinal signs of pseudarthrosis are inflammation and pain, and in a susceptible elderly person, it can create enough local pathology to maintain an active ulcer.

Electrical/flame burn to neck


The ulcer did not close with improved topical care and splints, so surgery was done. It was excised, including bone fragments and the arthrosis, and Integra was used to close the wound and the structures underneath. Seen here 11 days later, periwound inflammation is gone.

Fascial excision of chest

The wound healed and has remained so, seen here one year later.

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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