2005 Symposium on Advanced Wound Care | |
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Case Study
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Closure of a traumatic ankle wound in an elderly diabetic using combination modalities with oasis Alan J. Cantor, DPM, Donna Hangan, NP, Burn/Wound & Hyperbaric Medicine Center, Nassau University Medical Center, East Meadow, NY This 88 year old diabetic female, with a history of cardiovascular disease, presented with a traumatic wound of two week’s duration. The trauma was sustained in Florida and there she received proper emergency debridement and Vacuum Assisted Closure (VAC). She came to the wound center for split thickness skin grafting (STSG). A healthy granulating base was present; debridement was performed in preparation for STSG. The peri-wound area showed evidence of a hematoma. After assessment and discussion with family, asked if we could allow 4 weeks non surgical care to either reduce size of STSG or close Initial therapy consisted of Vacuum Assisted Closure (VAC) for one week. Following resolution of the hematoma, Regranex was applied under the VAC. Within two weeks granulation and epithelialization were noted. Oasis matrix dressing was then applied under Regranex and VAC continued. The rational for using the three therapies was to increase the efficacy of Regranex. Two weeks later a second graft was applied and the VAC and Regranex were discontinued. The size of the wound was reduced by half and therapy was changed to Oasis and foam, and in a further two weeks the wound healed. Total time of treatment was six weeks. However, because of the polytherapy used, it is difficult to determine which treatment provided the greatest benefit. |
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