Here - EWMA 2013

POSTER: CASE STUDY
Poster: Case Study
P 382
UNUSUAL CASE IN THE BURN DEPARTMENT – UNUSUAL TREATMENT
Gayane Mirzoyn 1 , Liudmila Budkevich1, Andrey Bistrov 2
1 Speransky Children Hospital (Moscow, Russia);
2 Russian Children Hospital (Moscow, Russia).
Aim: We want to demonstrate the unusual case the successful treatment of congenital
skin necrosis of the head 3% TBS by newborn girl. There was also a defect of soft
tissues parietal regions of head and in the projection of the sagittal sinus.
Methods: By CT-scan there was extensive bone defect 4.5 cm x 14 cm. Woundgrund
was non-structural brain membranes, convecsital surface of both parietal lobes of the
brain and the upper sagittal sinus. The first we used local conservative treatment with
alginate and hydrocolloids dressing. Than – different surgical modalities: local tissue
rearrangement, necrectomy, d-bridement, transplantation matrix with stem cells, skin
graft, technology “spray-on-skin”.
Results: First month and a half we applied only dressing and antibiotic therapy for fear
heavy bleeding from the sagittal sinus. But on the 46-th day it happened. Was performed
an operation plastic defect parietal regions in the zone of necrosis of the local tissues.
Area of the sagittal sinus covered formed patches. During bandaging are marked with
signs of ischemia skin flaps. The total area of necrosis has increased to 5% TBS. We
decided on the active surgical tactics. Was performed necrectomy, d-bridement the
wound with hydro surgical system, transplantation matrix with stem cells. After 5 days
made repeated transplantation matrix. After another 5 days the wound was covered with
meshed 4:1 autograft with transplantation autocells “spray –on-skin”. We observed an
incomplete (90%) epithelialization on the 9-th day, total – on the 17-th day after graft.
P 383
Poster: Case Study
Surgical wound dehiscence, recovery with medication to the
idrofibra and silver: Case report
Emanuele Grasso 1 , Francesco Di Vita 2
1 Ambulatory General surgery (Bisceglie, Italy);
2 Ambulatory General Surgery (Catania, Italy).
Introduction: The authors describe a case of surgical wound dehiscence cured with
advanced silver medications.
Materials and Methods: Surgical wound dehiscence with use of prosthesis in prolene
for hernia in 37 year-old man without in partnership pathologies. The patient operated in
urgency for median hernia from previous intervention in fifth day introduced erythema
post intervention, with dehiscence of the points of suture and spillage of serum-purulent
exuded. The patient was submitted in ambulatory to surgical toilet. Besides the
abstersion of the wound effected with repeated washings using physiological solution
and povidone – iodize to 10% of it, therefore he proceeded to application of the hollow
with advanced medications. In this case it is chosen to use idrofibra with silver
(carbossimetilcellulosa with silver). The medications were performed for the first 15 days
to alternate days, subsequently every 4 days.(Fig.1*). After 20 days well formed fabric of
granulation was gotten on the edges with absence of fibrina. The complete recovery was
achieved after 40 days. (Fig.2*)
Discussion and Conclusions: The deiscenza of the wound represents without doubt a
failure of the surgical line. Often these wounds are subject to new operation, but the use
of the idrocolloidis has allowed to reduce the conspicuous loss of cutaneous substance
activating the process of granulation and the migration of the fibroblastis and the
macrofagis. In our case, have allowed in short times of recovery of about 10-15 days
getting a complete recovery to about 40 days with acceptable aesthetes results.
*Figures not available in abstract book
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
221