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 3 Figure 4

Figure 1 A 62 year old patient fractured an ankle requiring surgical placement of pins. Patient was in a cast for six weeks. Cast was removed exposing infection, tissue loss and exposure of pins.  

Figure 2 The wound is cleansed and debrided. 

Figure 3 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. Proxiderm Model D 460 are utilized. Appearance at 23 hours.

Figure 4 Wound closed after 5 applications of Proxiderms over 10 days. Appearance at 3 months.

Case Report 2

Figure 1 Figure 2

Figure 1 A 60 year old patient fractured an ankle which was repaired with plates. The patient was placed in a cast and developed an ulcerative wound that did not heal under conservative treatment for 5 months. The defect was 1.5 cm by 1 cm and the plate was exposed.

Figure 2 Application of D 460 Proxiderm.

Figure 3 Figure 4

Figure 3 Proxiderms were applied daily for three days and the wound was sutured closed on day two. 

Figure 4 Appearance at 45 days

Figure 1 Figure 2 Figure 3

Figure 1 Four years previous a 70 year old severe cardiac patient fractured an ankle which was repaired with pins. Four months ago the patient developed an ulcerated wound with exposure of the pins. Appearance after debridement and removal of pins.

Figure 2 After 3 daily applications of Proxiderm models D 460 the wound was approximated and sutured closed. After closure by suture the Proxiderms were applied for an additional day to allow the suture line to heal in a tension free environment.

Figure 3   Appearance at 6 weeks

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