Application in an Abdominal Surgical Dehiscence
William Vassy, MD, FCCS
Trauma Surgeon – Northeast Georgia Physicians Group Northeast | Georgia Medical Center – Gainesville, GA
Pre-operative Assessment
Week 25
Results
- 100% depth reduction by week 5
- No complications
- Closure by secondary intention
- Single Myriad application
Patient details
53-year-old female
Medical history
High BMI, history of ventral hernia with repair
Case details
- Description: Full thickness dehiscence with exposed mesh
- Approximate Size: 20 cm x 18 cm x 4 cm with circumferential undermining
- Etiology: Surgical dehiscence
Application photos
Week 0 - Myriad Application
- Applied Myriad Morcells (1000 mg, dry), along the deepest part of the wound, then rehydrated in sterile saline
- Then applied two Myriad Matrix (10 x 20 cm, 3-Layer) trimmed to size
- Secondary dressing: NPWT at 125 mmHg
Week 2
- Graft well-adhered
- Note the black discoloration from the bismuth of the occlusive petroleum non-adherent layer interacting with sulfur from gastrointestinal tract (pictured)
- No complications
Week 3
- Significant reduction in depth
- Undermining eradicated around periphery
- Myriad continues to integrate
- No complications
Week 5
- 100% Depth reduction
- No complications
- Plan for healing by secondary intention
Week 25
- No complications and wound continues to reduce
- Measurement: ~4.5 cm x 3 cm
- Approximately 97% reduction in wound area
- One application of Myriad: Continued closure by secondary intention
Results may vary. Dr. Vassy has a consultancy agreement with Aroa Biosurgery Limited.