Application over Exposed Bone and Tendon with NPWT

Igor Zilberman, DPM

South Florida Lower Extremity Center, Hollywood, FL
Initial Assessment
Week 15

Results

  • Foot salvaged
  • Fully closed and re-epithelialized in 15 weeks using Endoform

Patient details

41-year-old male

Medical history

  • Hypertension and diabetes​
  • Presented to emergency room with cellulitis, swelling and a blister on right hallux and metatarsal​
  • Abscess was noted on the right lateral dorsal foot​
  • MRI revealed osteomyelitis

Case details

  • Wound age:​ 5+ weeks​
  • Wound size: 9.8 x 7.0 x 0.5 cm
  • Previous Treatments:​ NPWT and hydrogel
  • Treatment: Endoform Natural plus NPWT

Application photos

Initial Assessment

  • Wound size: 9.9 x 7.0 x 0.5 cm

Week 2

  • Exposed tendons still visible​
  • Granulation tissue forming in the wound bed​
  • No evidence of infection

Week 2 - Application of Endoform Natural and NPWT

  • Endoform Natural placed in the wound bed
  • Endoform secured using non-adherent plus Steri-Strips™
  • NPWT applied

Week 4

  • Endoform Natural and NPWT continued with twice weekly dressing changes
  • Granulation tissue starting to cover tendons
  • Rolled edges starting to flatten

Week 6

  • Granulation tissues covers most of tendons – still 20% tendon exposed (arrow)
  • Advancement of epithelial tissue

Week 8

  • Wound bed fully covered in granulation tissue
  • No exposed tendons
  • Further epithelialization (arrow)

Endoform Natural plus NPWT

  • 100% re-epithelialized

​Results may vary. Dr. Igor Zilberman has a consultancy agreement with Aroa Biosurgery Limited.
Steri-Strips™​ is a trademark and property of the respective owner.

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