Application in a Dehiscence Post Charcot Reconstruction – Exposed Bone and Joint
Richard Kaufman, DPM, CWSP
Piedmont Atlanta Hospital – Atlanta, GA
Intra-operative Defect
Post-op Week 12
Results
- 100% epithelialized at week 12
- No complications
Healed by secondary intention with Endoform
Patient details
52-year-old male
Medical history
Uncontrolled Diabetes Type 2 Charcot, Arthropathy, peripheral arterial disease
Case details
- Description: Full thickness wound with deep sinus and exposed bone and joint
- Etiology: Surgical dehiscence status post Triple Arthrodesis/Medial Column fusion with internal and external fixation
- Plan: Surgical debridement, IV antibiotics
Application photos
Week 0 - Defect filled with Myriad Morcells and Myriad Matrix
- Left ankle debridement with external fixator
- Applied Myriad Morcells (1000 mg) into deep tunnel with Myriad Matrix (5 x 5 cm, 3-Layer) overlay
- NPWT secondary dressing
Week 1
- Graft well adhered
- No complications
Week 2
- Robust granulation
- 100% depth filled
- Covered exposed bone and joint
- No complications
- Plan for return to OR to remove external fixation, wound debridement and possible 2nd application of Myriad Matrix
Week 4
- Myriad Matrix (5 x 5 cm, 3-Layer) well adhered
- No complications
- Discontinue NPWT, applied bolster secondary dressing
Week 6
- Residual Myriad Matrix removed revealing 100% granular wound bed
- Defect filled with viable soft tissue
- Covered exposed bone and joint
- No complications
- Plan to heal by secondary intention with Endoform Natural
Week 10
- 80% epithelialized
- No complications
- Continue to close via secondary intention with Endoform
Week 12
- 100% epithelialized
- No complications
Results may vary. Dr. Kaufman has a consultancy agreement with Aroa Biosurgery Limited.
