title: Management of Open Lower Extremity Wounds With Concomitant Fracture Using a Porcine Urinary Bladder Matrix.
abstract: BACKGROUND
  Open wounds of the distal third of the leg and foot with exposed bone, fractures, and hardware are challenging wounds for which to achieve stable coverage. The orthopedic advances in lower extremity fracture management over the last 30 years have allowed a rethinking of the standard operative approach to close these complex wounds.
  
  
  METHODS
  The ability of extracellular matrix (ECM) products to facilitate constructive remodeling of a wound seemed a reasonable approach for treatment, especially in patients who are often poor surgical candidates for more advanced reconstructive procedures.
  
  
  RESULTS
  The authors reviewed 9 patients with 11 open fractures of the leg, ankle, or foot treated with a newer ECM wound healing device to total closure. The clinical course and patient management are reviewed.
  
  
  CONCLUSIONS
  The authors conclude that newer ECM products can provide a reasonable method of management for patients who have wounds with exposed hardware, distal leg wounds, and open foot fractures compared to prolonged negative pressure wound therapy or complex reconstructive operative procedures.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Kraemer
authors.forename: Scott E
authors.initials: SE
authors.lastname: Geiger
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Deigni
authors.forename: John Tracy
authors.initials: JT
authors.lastname: Watson
mesh_terms: D000818:Animals; D003646:Debridement; D005597:Fractures, Open / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013552:Swine; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology* / Q000637:transplantation; D014945:Wound Healing