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 A 66 year old diabetic with a Charcot Foot deformity and a ulcer of 150 days duration. The ulcer measured 2 cm by 1 cm and was 4 cm deep. Proxiderm Model D 460 are utilized.

Figure 2 After three applications of Proxiderms the wound was closed in 16 days.

Figure 1 A 58 year old insulin dependent neuropathic diabetic with a charcot foot deformity and an ulcerative wound. Appearance after debridement.

Figure 2 Protruding bone excised. Prior to Proxiderm tissue expansion, sutures are placed 1.5 cm apart to approximate the wound margins and the wound is packed with Xeroform. Proxiderm models
D 460 are applied.

Figure 3 Figure 4

Figure 3 Appearance at 2 days. There were four applications of Proxiderms over 5 days.

Figure 4 As the patient started to walk there was swelling with edema and the wound separated on the 15th day. The wound was debrided and resutured.  Appearance at 18 months, no recurrence.

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