Application in a Traumatic Abdominal Defect
Romeo P. Massoud, MD
General Surgery – Acute Care and Trauma. Northside Hospital Gwinnett – Lawrenceville, GA
Initial Defect
Day 59
Results
- Eradication of depth to level of surrounding skin
- No complications
- No recurrence as of 11-months
- Single Myriad application
Patient details
44-year-old male
Medical history
No notable history
Case details
- Abdominal defect due to gunshot wound to the abdomen and chest
- Laparotomy for hemorrhage control and multiorgan injury requiring multiple procedures and resulting loss of abdominal domain
- Unable to close fascia primarily due to loss of domain, Myriad used to facilitate dermal closure with planned ventral hernia
- Approximate size ~25 cm x 10 cm
Application photos
Day 0 - Myriad Application
- Irrigation and debridement
- Application of Myriad Morcells (2000 mg) hydrated in situ with sterile saline and blood
- Covered with Myriad Matrix (3-Layer, 10 x 20 cm) trimmed to size
- Applied contact layer and wet-to-dry dressings
Day 7
- Budding of granulation tissue noted as the Myriad graft integrates
- No complications
Day 12
- Significant formation of granulation tissue
- Note dark coloration of residual Myriad
- Firmly adhered residual Myriad kept intact and rehydrated with saline
- Loosely adhered residual Myriad lightly debrided
- No complications
Day 16
- Continued integration of residual Myriad graft
- Non-adherent residual Myriad gently debrided
- No complications
Day 27
- Little residual Myriad graft noted
- No complications
Day 36
- Well-vascularized neodermis filled to the level of surrounding skin
- Reduction in defect volume
- No complications
- Planned for split thickness skin graft (STSG) (performed 10 days later)
Day 59 (21 days post STSG application)
- 90% take of STSG
- No complications
- One application of Myriad
- No recurrence as of 11-months
Results may vary. Dr. Massoud has a consultancy agreement with Aroa Bisourgery Limited.
