title: The use of nanocrystalline silver for the treatment of massive soft tissue defects with exposed bone.
abstract: BACKGROUND
  In a complex wound with exposed tendon, joint or bone caused by trauma, soft tissue reconstruction is required to obtain function and aesthetic coverage. Surgical reconstruction can be performed using a variety of different techniques.
  
  
  OBJECTIVE
  The authors report their experience using a nanocrystalline silver with or without vacuum assisted wound closure to salvage the exposed vital structures such as bone, joint or tendon in traumatic wounds.
  
  
  METHODS
  The present study included 12 patients with 15 wounds that exposed vital structures especially in the lower extremities. After adequate debridement, four wounds were treated with nanocrystalline silver dressing and vacuum assisted wound closure, and ten wounds were treated in an out-patient program using nanocrystalline silver dressing.
  
  
  RESULTS
  A preliminary evidence of impressive result was achieved with subsided infection and complete bony coverage by granulation tissue after treatment. Subsequently, a secondary healing or a split thickness skin graft was applied.
  
  
  CONCLUSIONS
  The authors present the satisfactory results of alternative techniques that may be used for the massive soft tissue defects with exposed bone.
authors.affiliation: Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand. kamoje@kku.ac.th
authors.forename: Kamonwan
authors.initials: K
authors.lastname: Jenwitheesuk
authors.affiliation: Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Palakorn
authors.initials: P
authors.lastname: Surakunprapha
authors.affiliation: Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Bowornsilp
authors.initials: B
authors.lastname: Chowchuen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D053768:Metal Nanoparticles / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D018030:Silver Compounds / Q000627:therapeutic use*; D017695:Soft Tissue Injuries / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018030:Silver Compounds