Combined use of fenestrated-type artificial dermis and topical negative pressure wound therapy for the venous leg ulcer of a rheumatoid arthritis patient.
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| Abstract |
We report a case of circumferential venous leg ulcer in a rheumatoid arthritis patient. Mesh skin grafting was performed in another hospital, but the graft failed and the patient was referred to our hospital. This ulcer was treated by the combination therapy of a fenestrated-type artificial dermis with negative pressure wound therapy (NPWT) and secondary mesh grafting using our 'grip tape technique'. NPWT was started at -100 mmHg and continued until the formation of dermis-like tissue. A section stained using haematoxylin and eosin and an anti-αSMA (α smooth muscle actin) immunohistological section of the biopsy from dermis-like tissue showed an abundant infiltration of fibroblasts and capillary formation beneath the fenestration of the silicone sheet. Threefold mesh skin grafting was subsequently performed and it was taken up completely. The fenestrated-type artificial dermis in combination with NPWT produced good results without infection in the treatment of complex wounds. In addition, our 'grip tape technique' was useful to apply polyurethane foam to the entire surface of the lower leg.
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| Authors | Naoki Morimoto, Atsuyuki Kuro, Takashi Yamauchi, Ai Horiuchi, Natsuko Kakudo, Michiharu Sakamoto, Kenji Suzuki, Kenji Kusumoto |
| Journal | International wound journal (Int Wound J) Vol. 13 Issue 1 Pg. 137-40 (Feb 2016) ISSN: 1742-481X [Electronic] England |
| PMID | 25650053 (Publication Type: Case Reports, Journal Article) |
| Copyright | © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd. |
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