Here - EWMA 2013

ORAL PRESENTATIONS
81
Free Paper Session: Acute Wounds
Treatment of Acute Wounds at Partial Deffects on Extremities
Cedomir Vucetic 1 , Javorka Delic 2 , Sasa Borojevic 3 , Jelena Jeremic 4 , Goran Tulic 5 ,
Radovan Manojlovic 5 , Boris Ukropina 5 , Bojan Karovic 5 , Zvonko Carevic 5
1 Clinical Centre of Serbia (Belgrade, Serbia);
2 City Institute for Skin and Venereal Diseases (Belgrade, Serbia);
3 Institute for Cardiovascular Diseases ‘Dedinje’ (Belgrade, Serbia);
4 Clinic for Plastic Surgery (Belgrade, Serbia);
5 Clinic for Orthopaedic Surgery and Traumatology (Belgrade, Serbia).
Introduction: Acute wounds with tissue deffects are a great challenge in surgery of
trauma and demand various approach, according to type of the injury, extent of injury
and part of the extremity.
Aim: The aim of the work is to show some options in treatment of the acute wounds with
tissue deffects.
Method: 1.Wounds with deffects on distal part of the extremity can be treated without
shorthening, by covering the soft tissue deffects with transplants (B) or by amputation
with shortening (A).
2.Proximal, longitudinal soft tissue deffects (PLSTD) can be healed by soft tissue
transplants (STT).
3.PLSTD and bones can be healed on above described way, with saving the lenght of
the extremity and compensation of bone deffect (A) or by extremity shortening (ES) and
wound reducing and after that, if there is a need, with extremity’s lengthening (B).
4.Transversal or cicular deffects of soft tissue (TDST) can be treated by STT (A) or by
ES (B).
5.TDST and bones can be healed by using composite tissue transfers (A), by ES (B) or
by amputation (C).
Results: There were 15 wounds in group 1A, 3 on foot and 12 on hand. The skin grafts,
random flaps and free microvascular flaps were used for covering. There were 5 patients
in group 2 and free microvascular flaps, random flap and skin graft were applied. In
group 3B, there were 3 patients. There were 2 patients in group 4B, and ES was done.
In group 5B, there were 3 patients and distractive osteogenesis was done later, just as
in group 2.
Conclusion: Treatment of the acute wounds with tissue deffects on extremities by using
the transplants or by ressection and shortening on the place of the injury enables the
extremity saving, faster wound healing and infection prevention.
Key words: Acute wounds, treatment, tissue defects
FREE PAPER SESSION: LEG ULCERS II
82
Free Paper Session: Leg ulcers II
Results OF A NATIONAL MULTICENTER TRIAL WITH A FOAM DRESSING
IMPREGNATED WITH A MATRIX-METALLOPROTEINASES-INHIBITOR IN
OUTPATIENTS WITH CHRONIC WOUNDS
Karl-Christian Muenter 1 , Steffen Luetzkendorf 2 , Udo Moeller 3
1 Medical Practice (Hamburg, Germany);
2 Medical Practice (Helbra, Germany);
3 Urgo GmbH (Sulzbach, Germany).
Aim: A recently published double-blind RCT showed that a foam dressing impregnated
with a Matrix-Metalloproteinases (MMP)-Inhibitor speeds up the wound healing twice in
patients with venous leg ulcers compared to a neutral foam dressing. It was the aim of
our trial to demonstrate the efficacy and tolerance of this dressing in outpatients with all
type of chronic wounds.
Methods: A prospective, open labeled, non-interventional multicenter trial was carried
out in patients with all type of chronic wounds. The main evaluation criterion was the
evolution of wound surface area. Secondary criteria were the percentage of healed
wounds, tolerance and acceptance of the dressing, pain on dressing removal and the
state of the surrounding skin.
Results: 108 centers included 1528 patients. The median of wound surface area was
reduced from 7 cm 2 to 2 cm 2 after 44 days of treatment. 43,2% of the wounds healed.
The state of the surrounding skin improved markedly: 31,2% of the patients had healthy
skin at the end compared to 4,8% at inclusion. The local tolerance (acceptance) was
stated as „very good“ or „good“ in 79,1% and 19,1% respectively (76,6% and 21,9%).
The percentage of patients without pain during dressing change increased from 42,8% to
75,2%.
Conclusion: This trial showed good results in a high number of patients presenting
chronic wounds. The wound healing was kick-started due to the inhibition of MMP and a
very fast and considerable reduction of wound surface area was achieved.
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