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 1   A 58 year old insulin dependent neuropathic diabetic with an ulcer of 18 months duration. 

Figure 2   The ulcer is sharply debrided removing all non-viable tissue and excising a rim of fibro-cutaneous tissue from the margins. The wound margins were undermined at a supra-facial or deep subcutaneous level approximately 5 -10 mm. from the margins.

Figure 3   Prior to application of Proxiderms, 2/0 nylon sutures were placed and tied 1-2 cm from the wound margins at 2 cm intervals. Proxiderm model D 460 are applied

Figure 4 Figure 5

Figure 4 Appearance at 4 days. Wound was sutured closed after 4 applications of Proxiderms over 7 days. 

Figure 5 Initially when the patient started to walk the wound separated. The wound was resutured closed.  Appearance at two years, no recurrence

Case Report 2

Figure 1 Figure 2 Figure 3

Figure 1 41 year old diabetic injured foot by stepping on a nail. Wound became infected and ulcerated.   Wound was debrided and treated by conservative methods multiple times over 3 years with continual breakdown.

Figure 2 Appearance after debridement.  

Figure 3   Application of D 460 Proxiderms

Figure 4 Figure 5

Figure 4 Proxiderms were applied daily for 4 days. On the 7th day the wound edges were debrided and sutured and the Proxiderms applied for another day. Two weeks after discharge the wound separated. The wound was sutured closed and the Proxiderms applied for an additional 2 days.

Figure 5 Appearance at 3 months

Case Report 3

Figure 1 Figure 2 Figure 3

Figure 1 A  40 year old patient with a neuropathic ulcer of 10 years duration

Figure 2 Surgical excision of ulcer

Figure 3 Proxiderms applied on intervals of 2 to 3 days. Wound closed by suture in 10 days.

Appearance - 10 days Appearance - 30 days Appearance - 2 months

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