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  Excision
  Application
 
    Neodermis formation
  Signs of mature Neodermis
    Dressing regimen
    Bolstering and splinting
    Frequency of dressing changes
    Positioning the patient
    Moving and turning the patient
    Anti-shear techniques
    Physical Therapy
    Large Hematoma
    Small, late forming Hematoma
    Fluid accumulation
    Infection
 
    Areas of non-take
    Summary
  Summary
   


Complications - Infection at Staple
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Infection at Staple

Staples and seams should be checked carefully. This INTEGRA Template site requires intervention.

Intervention

  • "Unroof" silicone in affected area
  • Remove all signs of possible purulence. Aspirate or evacuate by incising/rolling.
  • Treat with topical antimicrobials - Irrigate INTEGRA Template sites at seams/edges and beneath the silicone layer with a topical antimicrobial such as Sulfamylon® Solution 5% solution/slurry, or silver nitrate 0.5% solution. Irrigate frequently (2-6 times daily)
  • Culture and initiate systemic antibiotics based on the clinical judgement of the practitioner
  • If aggressive treatment of purulence is not successful as evidenced by increasing purulence/pus, non-take of INTEGRA Template (i.e., a "floating" sheet) or silicone separation, then the affected area needs to be removed. Remove only the affected area.
  • Treat/Irrigate with topical antimicrobials
  • Treat as open wound until infection is resolved
  • Once infection is resolved, apply new INTEGRA Template sheet or treat with temporary covers (e.g., allograft) until ready to autograft

 

 
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