Application in an Open Hip Defect
Michael Cormican, MD
Trauma Surgeon – Northeast Georgia Physicians Group. Northeast Georgia Medical Center – Gainesville, GA
Pre-operative Assessment
Week 21
Results
- Eradication of depth
- Full epithelialization by week 13
- Healed by secondary intention
- Patient satisfied with scar and able to ambulate by week 21
- No complications
Patient details
36-year-old male
Medical history
No significant PMH
Case details
- Description: Full thickness right hip wound due to motor vehicle accident
- Patient arrived hemodynamically unstable, underwent ex-lap with REBOA placement
- Approximate size: 18 cm x 13 cm x 20 cm (max depth)
- Etiology: Blunt trauma due to motor vehicle accident
- Initial debridement and management with QuikClot®
- Debridement and application of Myriad scheduled for 4 days later
Application photos
Week 0 - Morcells Application
- Initial procedure: serial sharp debridement and lavage
- Application of Myriad Morcells (2000 mg) hydrated with blood in situ
- Secondary dressing: NPWT at 125 mmHg
- Plan for second operative evaluation and possible application of Myriad Matrix
Day 5 - Matrix Application
- Final sharp debridement and lavage
- Depth reduction noted (~2 cm) and notable development of budding granulation tissue noted (left)
- Application of Myriad Matrix (5-Layer, 10 x 20 cm, x 2 devices) hydrated with blood in situ, quilted together and secured to wound with staples (right)
- Secondary dressing: petroleum gauze contact layer and NPWT at 125mmHg
Day 8
- Petroleum gauze contact layer noted over integrating Myriad Matrix – contact layer left in place when changing NPWT dressing
- Integrating well, properly rehydrated
- Continue NPWT at 125 mmHg
Day 15
- Continued formation of robust, vascular granulation tissue as Myriad integrates
- Pain well-controlled
- No complications
Week 4
- Significant reduction of wound area and volume
- Pain well-controlled
- No complications
- Plan to heal by secondary intention, NPWT continued
Week 7
- 90% Reduction of depth and width
- Approximately 1 cm of depth remains
- No complications
- Continue to heal by secondary intention
Week 11
- 95% epithelialized
- No complications
- Fully epithelialized by Week 13
Week 21
- ~2-months after healing confirmed
- Patient highly satisfied with scar, able to ambulate
- No complications
Results may vary. Dr. Cormican has a consultancy agreement with Aroa Biosurgery Limited.
QuikClot® is a trademark and property of the respective owner.
