Application in a Gluteal Degloving Trauma
Christine Castater, MD Roberto Taarea, DO
General Surgery – Acute Care and Trauma WellStar Kennestone Marietta, GA
Pre-operative Assessment
Week 5
Results
- No infection or complications at week 5
- Complete reduction of undermining to the right side of the defect and near complete resolution of undermining on left side
- Depth filled with healthy, viable granulation tissue
Patient details
38-year-old, female
Medical history
- Presented with necrotizing soft tissue infection (NSTI) sustained after degloving injury to the buttocks due to motor vehicle accident
- Admitted to ICU
Case details
- Wound Size: 17 cm x 15 cm x 14 cm with 9 cm of undermining on the left side and 5 cm of undermining on the right side
- Exposed muscle, fascia, bone
Application photos
Week 0 - Post Debridement
- Initial Procedures: Multiple debridements, washout and a diverting loop colostomy due to proximity to anus
- Application of two Myriad Matrix (10 x 20 cm, 3-Layer) and Myriad Morcells (1000 mg)
- Secondary dressing: NPWT (at 125 mmHg)
Week 2
- Graft incorporating, islands of residual Myriad noted
- No infection or complications
- Reduced depth and undermining
- Discharged home with NPWT
Week 5
- No infection or complications
- Complete reduction of undermining to the right side of the defect and near complete resolution of undermining on left side
- Approximate measurements: 8.5 cm x 8.5 cm
- Healthy, viable granulation noted
- Referred to plastic surgeon in different health system for flap closure
Results may vary. Dr. Castater and Dr. Taarea have a consultancy agreement with Aroa Biosurgery Limited.