A case of lower-extremity deep burn wounds with periosteal necrosis successfully treated by use of allogenic cultured dermal substitute.
In patients with burns, bone exposure accompanies serious problems which occasionally lead to amputation. We present a case of an 82-year-old woman who sustained 22% of total body surface area flame burns on her bilateral lower extremities with bone exposure. Despite fascial excision and mesh skin graft, muscles, bones, and tendons were widely exposed on her right leg. The wound was infected by methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. To promote wound healing, we applied an allogeneic cultured dermal substitute (CDS) to the wound surface once weekly, resulting in healthy granulation except for the exposed bone area of the right anterior tibia. We then shaved the cortex of the exposed bone surface until bone marrow bleeding, and grafted mesh skin in combination with CDS. Finally, all wounds healed without osteomyelitis. The use of CDS to treat deep burns exposing bone surface may expand reconstructive options for extremities that otherwise might have been amputated.
Ohara
Naoki
N
Programs for Biomedical Research, Division of Molecular Medical Science, Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. n-ohara@shobara.jrc.or.jp
Mihara
Shoji
S
Nihara
Hiroyuki
H
Akimoto
Narihiro
N
Madokoro
Naoki
N
Kawai
Mikio
M
Noda
Hideki
H
Hide
Michihiro
M
Matsumoto
Yasuhiro
Y
Kuroyanagi
Yoshimitsu
Y
D000369:Aged, 80 and over; D002056:Burns / Q000473:pathology / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D009336:Necrosis / Q000473:pathology / Q000601:surgery; D010521:Periosteum / Q000473:pathology / Q000601:surgery; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D014945:Wound Healing