Open AccessTissue Engineered Successful Reconstruction of a Complex Traumatized Lower Extremity
Author(s) -
Srinjoy Saha
Publication year - 2021
Publication title -
journal of orthopaedic case reports
Language(s) - English
Resource type - Journals
eISSN - 2321-3817
pISSN - 2250-0685
DOI - 10.13107/jocr.2021.v11.i09.2390
Subject(s) - medicine , debridement (dental) , soft tissue , surgery , suction , thigh , biomaterial , wound healing , biomedical engineering , mechanical engineering , engineering
Tissue engineered reconstruction is a minimally invasive approach for healing major complex wounds successfully. It combines accurate, conservative debridement with a specially adapted suction method, platelet-rich plasma (PRP) injections, and biomaterial application to salvage injured tissues and grows new soft tissues over wounds.Case Report: A healthy young man in his early 30s presented to our emergency department with complex knee-thigh injuries following a high-velocity automobile accident. Degloved anterolateral thigh, severe thigh muscle injuries, and ruptured extensor patellar mechanism were observed. Accurate conservative (as opposed to radical) debridement and PRP injections salvaged the injured muscles and tendons. Specially carved reticulated foam wrapped around the injured ischemic muscles, followed by low negative, short intermittent, cyclical suction therapy. Wound exploration 4 days apart revealed progressive improvements with considerable vascularization of the injured soft tissues within 2 weeks. Thereafter, meticulous reconstruction of the salvaged muscles and tendons restored anatomical congruity. An absorbable synthetic biomaterial covered the sizeable open wound with vast areas of exposed tendons. Five weeks later, exuberant granulating tissue ingrowth within the biomaterial filled up the tissue defect. A split-skin graft covered the remaining raw areas, which “took” completely. Early rehabilitation enabled the patient to return to active work, play contact sports, and perform strenuous activities effortlessly.Conclusion: Minimally invasive tissue engineered reconstruction is a novel approach using a series of simple minimally invasive procedures. It lessens the duration of surgery and anesthesia, maximizes soft-tissue salvage, lowers morbidity, minimizes hospitalization, saves costs, and improves the patient’s quality of life significantly.Keywords: Mangled extremity, Limb salvage, Financial, Trauma, Modified negative pres