An open wound prevents a patient from returning to normal activities. It is always at risk for serious bacterial infections and should be closed quickly. The ideal wound closure requires local site, full thickness skin and sub-cutaneous tissue to withstand the stresses of daily living.

Case Report 1

Figure 1 Figure 2

Figure 1 An 87 old patient was injured when a TV set fell on the lower leg and heel area. Three weeks after the injury the achilles tendon was infected and necrotic, the defect measured 5.1 cm by 3.5 cm.

Figure 2 Prior to Proxiderm tissue expansion, sutures are placed 1.5 cm apart to approximate the wound margins. The use of rubber "booties" to diminish pressure on the skin by the tied sutures is optional. Appearance following 26 hours of Proxiderm tissue expansion.

Figure 3 Figure 4 Figure 5

Figure 3. In this patient the Proxiderm Model D460 was utilized. Proxiderms were applied on intervals of two to three days for a total of nine days.

Figure 4 Appearance on 5th post expansion day. On the 15th post expansion day there was a sufficient amount of granulation tissue over the tendon and the patient the wound was covered with  meshed split thickness skin graft.

Figure 5 Appearance at one month.

Figure 1 An 85 year old with peripheral vascular disease and an infected/exposed necrotic achilles tendon.

Figure 2 Prior to Proxiderm tissue expansion, sutures are placed 1.5 cm apart to approximate the wound margins. In this patient the Proxiderm Model D460 was utilized.

Figure 3 - (7 days) Figure 4 -( 11 days) Figure 5 - (30 months)

Figure 3 Proxiderms for twice for two days and once for three days.   Appearance at seven days.  

Figure 4 Proxiderms were removed for two days and then applied for an additional two days. Appearance at 11 days.

Figure 5 Appearance at 30 months.

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