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Case Study/Series
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Use of a collagen-glycosaminoglycan biodegradable matrix* and subsequent skin grafting for the treatment of acute and chronic osteomyelitis First Author: Karl Hekimian MD Authors: Carondelet St. Mary's Hospital Tuscon, AZ, Edye Calderon PA-C, Mario Lluria RN, Kathleen Jones CCLS, Vanessa Garcia PCT and Crysty Frick BSN. Osteomyelitis treatment typically entails debridement of infected bone and immediate coverage with vascularized tissue, often a muscle or fasciocutaneous flap. This can be difficult due to lack of healthy local tissue, health of the patient, compliance issues (including smokers) and donor site morbidity. It can also result in prolonged hospital courses and lengthy immobilization. A collagen-glycosaminoglycan biodegradiable matrix*, originally developed for use in burns, contains an outer layer of a thin silicone sheet and a deeper layer made of collagen and chondroitin that serves as a matrix for dermal regeneration. When placed on an open wound, it "takes" by invasion of cells and ingrowth that eventually replaces the deep layer with dermis-like autogenous tissue, causing the silicone layer to slough off. This allows subsequent closure with simple skin grafting in areas typically not amenable to skin grafting such as over bone or tendon. We here present a series of patients who underwent placement of collagen-glycosaminoglycan biodegradable matrix* directly on bone following debridement for osteomyelitis. After allowing time for the matrix to "take", a split-thickness or full-thickness graft was used for reconstruction. Patients were typically discharged within 2 days after placement of the matrix and 2-5 days after skin grafting. *Integraª Bilayer Matrix Wound Dressing Integra LifeSciences Plainsboro, NJ |
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