The management of skin deficit wounds, wounds that dehisce and contaminated wounds is frustrating and time consuming.  The Proxiderm can simplify a difficult procedure, avoid general anesthesia with its associated complications, is less traumatic and results in a quicker recovery

Case Report 4

Figure 1 Figure 2

Figure 1   A 59 year old patient with an abdominal dehiscence measuring 10 cm by 10.4 cm the result of a previous hernia procedure

Figure 2 Appearance after 3 months of conservative treatment with poor epithelialization and continuous wound breakdown and bleeding.   This wound dehiscence was costly.  Patient required continual dressing changes, hospitalization, nursing and physician care. There was also the constant risk of the development of costly infective episodes Patient referred for closure by Prodiderm.

Figure 3 Figure 4 Figure 5

Figure 3 Scar tissue was excised leaving a wound measuring 13.7 cm by 14.2 cm

Figure 4 The wound margins are approximated by #2/0 nylon sutures placed through red rubber "booties" to diminish pressure on the skin and tied 1-2 cm from the wound margins at 2 cm intervals. The ends of the tied sutures are left long, later they will be looped around the Proxiderms for increased stabilization. Additional #2/0 nylon sutures are placed between the tied sutures, and the ends are secured by steristrips; these sutures will be tied at the next application of Proxiderms.

Figure 5   The wound is lightly packed with dressings impregnated with anti-microbial medication of the physicians choice, Proxiderm model PS 460s and D 460 are applied, the spacing between the Proxiderms is approximately 2 cm.

Figure 6 Figure 7

Figure 6   After  4 daily applications of Proxiderms, 2 days of dressing changes followed by one two day application of Proxiderms, the wound was closed by suture on eighth day.   Proxiderms were applied for an additional day after wound was closed by suture to allow the suture line to heal in a tension free environment.

Figure 7   Appearance at 20 days post closure.

Case Report 5

Figure 1

Figure 1   A 55 year old patient underwent coronary artery bypass surgery. The wound dehisced and was closed by a TRAM flap.   One week later, the TRAM flap also became necrotic and dehisced.  Photo; post TRAM flap abdominal wound of 55 days duration. Patient referred for closure by Proxiderm.

Figure 2 Figure 3

Figure 2   Appearance after debridement, the wound measured 24 cm by 8 cm. and was 4 cm deep. Proxiderms models PS 460 and D 460 were used by the physician and spaced 1-2 cm apart. Four by four dressings and combines are placed beneath the ends, between and over the Proxiderms.  The Proxiderms and padding are secured to the patient by Elastoplast and/or adhesive tape.

Figure 3   Proxiderms were applied for a total of 15 days.  The wound was evaluated at two to three days intervals. Appearance at 16 days. (see arrows)

Case Report 6

Figure 1 Figure 2

Figure 1 A 49 year old patient had by-pass surgery, developed a sternal infection which was covered with an omental tissue flap. One month later there was an abdominal dehiscence, a large medical dehiscence of the left thigh, a dehiscence of the right thigh and a wound dehiscence of the left ankle with exposed tendon. The abdominal dehiscence measured 5.1 cm by 14.2 cm.  All wounds were treated simultaneously. Appearance after debridement.

Figure 2   Prior to application of  Proxiderms, wound margins are undermined and #2/0 nylon sutures are placed and tied 1-2 cm from the wound margins at 2 cm intervals to approximate the wound.  The wound is lightly packed with dressings impregnated with anti-microbial medication of the physicians choice. The physician used Proxiderm model D 460s which are placed 1-2 cm apart.

Figure 3 Figure 4

Figure 3   The wound was closed by suture on day 4, after 4 daily applications of Proxiderms. The Proxiderms were applied for an additional day to allow the suture line to heal in a tension free environment. Appearance at 3rd post closure day. Wound was closed by suture on day 4.

Figure 4   Appearance at 2 months

Case Report 7

Figure 1 Figure 2 Figure 3

Figure 1   A 50 year old patient with auto immune disease and a large defect in the abdominal wall measuring 8.5 by 19 cm with  exposure of mesh and a left ileostomy bag.  Major problem with closure was a leaking ileostomy in the superior aspect of the wound .

Figure 2 Prior to application of Proxiderms, wound margins are undermined and #2/0 nylon sutures were placed and tied 1-2 cm  from the wound margins at 2 cm intervals to approximate the wound. The wound is lightly packed with dressings impregnated with anti-microbial medication of the physicians choice.    Proxiderm models (PS 460) are applied,  the spacing between the Proxiderms is approx. 2 cm

Figure 3   The wound was closed by suture on day 4, after 4 daily applications of Proxiderms, This was followed by an additional two days of Proxiderm application to allow the suture line to heal in a tension free environment. Appearance at 19 days.  No recurrence in 40 months.

Additional Cases

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