Application in a Reconstruction following Fibromatosis of the Plantar Foot
Abigail E. Chaffin, MD, FACS, CWSP, MAPWCA
Professor of Surgery Chief, Division of Plastic and Reconstructive Surgery Program Director, Tulane University/Ochsner Clinic Plastic Surgery Residency Program Medical Director, MedCentris Wound Healing Institute Metairie Department of Surgery, Tulane University School of Medicine
Wide Excision
3 Months post STSG
Results
- 99% healed at 21 days, 100% at 3-months
- Soft pliable regenerated tissue
- Patient walking in regular shoe
Patient details
60-year-old male
Medical history
- No significant PMH
- Presented with recurrence of plantar fibromatosis to left foot
Case details
- Previously had 3 local excisions
- Feels like the patient is “walking on rocks”
- Decision made for full thickness excision with wide margins and Myriad Matrix placement
Application photos
Wide Excision
Myriad Placement – 10 x 20 cm, 3-Layer
Day 4
- Myriad graft well adhered
- No infection or complication
- Granulating tissue visible
- Continue with NPWT
Day 10
- Myriad graft fully integrated
- No complications or infection
- Complete coverage of exposed tendons
- Thin coverage of 1st MTP joint
- Endoform Natural placed over 1st MTP joint then resumed NPWT
- Gentian violet solution at the periwound to help prevent maceration
Day 19
- Coverage of 1st MTP more robust
- Some residual Endoform seen over the 1st MTP
- Endoform Natural placed over 1st MTP joint twice weekly
Day 32
- Complete coverage and fill with well-vascularized tissue
- Continue application of Endoform twice a week with plan for STSG in two weeks
14 Days post STSG
- 100% STSG take
21 Days post STSG
- 99% healed
- Off-loading orthotic being fitted
3 Months post STSG
- 100% healed
- Soft pliable tissue
- Patient walking in a regular shoe, with custom orthotic
Results may vary. Dr. Chaffin has a consultancy agreement with Aroa Biosurgery Limited.