title: Biobrane in the management of critical microsurgical wounds of the upper extremity.
abstract: OBJECTIVE
  Evolving soft tissue necrosis and/or edema can complicate microsurgical reconstruction by leading to open wounds with exposure of critical structures: anastamosed vessels, nerves, and tendons. Not infrequently, primary closure of these wounds is not possible. Immediate skin grafting may lead to anatomical and/or functional failure of reconstructed structures, compromising immediate or long-term functional outcomes. In addition, local tissues are often unavailable, and free tissue transfer in those settings could be ill-advised, especially for small wounds.
  
  
  METHODS
  All of the senior author's microsurgical cases were reviewed. Four cases of replantation and one microsurgical reconstruction, where biologic dressings were used to treat critical wounds, were identified and are presented in this study along with an algorithm for the management of these types of wounds.
  
  
  RESULTS
  Biologic dressings are simple, effective, and reliable tools for intermediate treatment of critical microsurgical wounds. Flap or replant viability was preserved in 100% of cases without compromising functional results.
  
  
  CONCLUSIONS
  Biologic dressings can be used safely to treat microsurgical wounds with exposed critical structures. This use of a biologic dressing greatly simplifies the management of these types of wounds, avoiding the need for complex surgical intervention.
authors: Division of Plastic Surgery, Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA. naveen.ahuja@gmail.com
authors: Naveen K
authors: NK
authors: Ahuja
authors: Ramazi O
authors: RO
authors: Datiashvili
mesh_terms: D000328:Adult; D000465:Algorithms; D001134:Arm Injuries / Q000601:surgery*; D002648:Child; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D003661:Decision Support Techniques; D005260:Female; D058752:Free Tissue Flaps; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009779:Occlusive Dressings; D019651:Plastic Surgery Procedures / Q000379:methods*; D012092:Replantation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control; D014945:Wound Healing
chemical_list: C042816:Biobrane; D020099:Coated Materials, Biocompatible