Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 552
USE OF URINARY BLADDER MATRIX IN COMPLICATED OPEN WOUNDS
E-Poster: Case Study
Alexis Parcells 1 , Ramazi Datiashvili 1
1 University of Medicine and Dentistry of New Jersey (Newark, United States)
Aim: Management of complicated open wounds, particularly of those with exposed
bones, represents a challenge when reconstructive options are not applicable. Scaffolds
derived from urinary bladder matrix (UBM) provide a biocompatible material that allows
inductive tissue remodeling.
Methods: We present two cases of use of UBM in the treatment of the large
complicated open wounds with exposed bones.
Results: One patient sustained severe traumatic crushing degloving injuries to both
hands resulting in large complicated open wounds with exposed metacarpals over the
dorsal aspects of the hands. Character of wounds precluded use of local or free flap for
reconstruction. The wounds were managed by serial debridement and application of
UBM. This application provided tissue remodeling over the bones and allowed
successful skin grafting of the wounds with satisfactory functional outcome.
Another patient sustained a severe crushing injury to her right knee. In an outside
institution, the wound was debrided and patella was removed. The patient developed a
large wound of the anterior knee with exposed knee joint. In the same institution, a
gastrocnemius muscle transfer and rectus abdominus muscle free flap transfer failed.
The patient developed occlusion of superficial femoral artery and acute deep venous
thrombosis, which precluded further reconstructive surgeries. We managed the wound
by application of UBM and Topical Negative Pressure*. As a result, the wound
completely closed and epithelialized.
Conclusion: Our experience shows UBM as a promising, effective method in
management of complicated open wounds in selected cases. Further studies are
needed to confer this conclusion.
Reference: Acell Urinary Bladder Matrix (acell.com)
* VAC
E-POSTER: CASE STUDY
EP 553
E-Poster: Case Study
Successful treatment of a radiotherapy induced chronic wound
with hyperbaric oxygen therapy
Gunalp Uzun 1 , Fatih Candas 2 , Mesut Mutluoglu 1 , Hakan Ay 1
1 GATA Haydarpasa Teaching Hospital Department of Underwater and Hyperbaric
Medicine (İstanbul, Turkey);
2 GATA Haydarpasa Teaching Hospital Department of Thoracic Surgery (Istanbul,
Turkey).
Aim: To describe a patient with post radiation therapy wound, which was successfully
treated with hyperbaric oxygen (HBO) therapy. HBO therapy involves the administration
of 100% oxygen at pressures higher than 1 atmosphere absolute. HBO enhances
fibroblast growth, increases collagen formation, stimulates angiogenesis in radiationinjured
tissue and promotes epithelialization. The treatment is provided in a mono-place
or multi-place hyperbaric chamber. The patient breathes 100% oxygen through a mask
or head tent.
Methods: A 59-year-old male patient presented with a large deep non-healing wound
over his left scapula which had occurred following a long course of radiotherapy for a
lung cancer. Since conventional wound care and a number of surgical operations failed,
the patient was referred to our department for HBO therapy. HBO therapy was combined
to the standard wound care management protocol and the patient received HBO therapy
at 2.4 atmospheres absolute for 2 hours on weekdays in a multi-place chamber.
Results: The patient received a total of 40 HBO sessions. Over the course of HBO
therapy, the wound gradually showed progress towards healing and at the end of 3
months, it was almost fully epithelialized.
Conclusion: Post radiation therapy wounds may fail to heal with conventional
treatments. HBO may contribute to the healing process of radiotherapy induced chronic
wounds.
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