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Product Description and Benefits
  Indications for Use
  Product Makeup/Histology
  Clinical Sequence
 
    Venous Stasis Ulceration
    Ulceration to both feet and anterior ankles
    Trans-metatarsal amputation
    Traumatic degloving calcaneal fracture
    Stump Salvage
    Achilles Ulcer
    Exposed Bone
    Chronic Venous Ulceration
 
    Exposed Joint
    Limb Salvage
    Leg Ulceration
    Arterial Disease
    Hypercoagulable Disorder
    Ankle Ulcer
    Ischemic Ulceration
    Forefoot Ulceration
    Heel Ulcer
    Summary
  Summary
   


Immunopathic Wound
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A 71-year-old woman had an ulcer of the lateral left leg and ankle. She was treated for 4 years for "venous ulceration", but multifocal lytic ulceration, exposure but sparing of muscles and tendons, distribution along tendon sheaths, absence of venous pigment and edema, and various musculoskeletal symptoms are all paradigm features of rheumatoid and similar immunopathic wounds.

Electrical/flame burn to neck


After making and confirming the diagnosis of rheumatoid arthritis, anti-inflammatory and anti-metabolic treatments were started. The wound was excised and closed with Integra, including coverage of bare fibular cortex and multiple muscles and tendons.

Fascial excision of chest

The involved area healed quickly and has remained healed ever since, seen here at 6 months.

INTEGRA® Dermal Regeneration Template

Two years later, the patient became very ill with disease flare-up. Rheumatoid panniculitis and multifocal ulceration occurred on both lower extremities, seen here on the medial side of the left leg. Topical wound care, compression and edema control, intralesional steroids, and increased systemic therapy brought the acute problems under control, but left multiple open wounds.

INTEGRA® Dermal Regeneration Template

This image is simultaneous to the previous. Whatever else has happened nearby, the original lateral leg reconstruction remained healthy throughout the acute flare-up.

INTEGRA® Dermal Regeneration Template

The new ulcers on the medial side of the leg did not heal after a suitable period of topical care and observation. Integra was then used, and all healed, seen here 9 months later.

INTEGRA® Dermal Regeneration Template

Cases Courtesy of:
Marc E. Gottlieb, M.D., Jennifer Furman
Journal of Burns and Wounds, Vol 3, #2

 
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