title: Chronic ischaemia does not appear to hinder healing with Integra(®) : implementation at a tibial artery bypass site.
abstract: Wounds with exposed vessels, especially in artery bypass procedures, can pose a barrier to adequate skin healing. Skin grafts or flaps are sometimes difficult to perform in the face of the ischaemia that is often present in such cases. We report a case of a 73-year-old man who presented with grade IV peripheral arterial disease necessitating salvage of the lower limb using artery bypass surgery. Immediate exposure of femorotibial artery secondary to skin necrosis following the bypass led us to propose an innovative means of wound coverage using Integra(®) , a well-known dermal regeneration template. The wound healed uneventfully with an appearance similar to that of the adjacent skin. Integra(®) seems to be less demanding in terms of the vascular wound bed and the degree of oxygenation than a conventional skin graft. This finding could support further indications for this dermal regeneration template.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Bordeaux Segalen, Bordeaux, France. audrey.michot1@gmail.com.
authors.forename: Audrey
authors.initials: A
authors.lastname: Michot
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Toulouse Rangueil, Toulouse, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Chaput
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Bordeaux Segalen, Bordeaux, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Gobel
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Bordeaux Segalen, Bordeaux, France.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Menez
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Toulouse Rangueil, Toulouse, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: de Bonnecaze
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Bordeaux Segalen, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Pelissier
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male; D058729:Peripheral Arterial Disease / Q000601:surgery*; D012038:Regeneration; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D016909:Tibial Arteries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: Artificial dermis; Chronic ischaemia; Dermal regeneration template; Integra®; Vascular bypass