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 33 year old with a neuropathic ulcer exposing bone and tendon. An exposed tendon is always subject to deterioration and it is essential to cover the tendon as quickly as possible

Figure 2 Outpatient procedure. Wound evaluated on intervals of 2-3 days and was closed after seven days of Proxiderm application. Physician used Proxiderm model D 460. Appearance at 10 days.

Case Report 2

Figure 1 Figure 2

Figure 1   A 49 year old diabetic with a small metatarsal ulcer.

Figure 2   Application of Proxiderm model D 460 for 2 days.

Figure 3 Figure 4

Figure 3 Wound sutured closed on day 3

Figure 4 Appearance at 34 months.

Figure 1 Figure 2 Figure 3 Figure 4

Figure 1 A  43 year old diabetic patient with an ulcer of 18 months duration measuring
 2.1 cm by 2.5 cm.

Figure 2 Initially 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-fascial or deep subcutaneous level approximately 5 -10 mm. from the margins. Nylon sutures were placed and tied 1-2 cm from the wound margins at 2 cm intervals. The use of rubber "booties" to diminish pressure on the skin by the tied sutures is optional. The ends of the tied sutures are left long, later they will be looped around the Proxiderms for increased stabilization.  

Figure 3   The wound was lightly packed with dressings impregnated with anti-bacterial medication. 

Figure 4.  Application of Proxiderms, model D 460

Appearance 4 days Appearance 1 month Appearance 3 months Three applications of Proxiderms over 7 days. The wound was sutured closed on day 7

Figure 1 A 43 year old severe diabetic with an metatarsal ulceration. Three previous graft and flap procedures failed.    

Figure 2 Proxiderm model D90 460 used in first application. Additional applications utilized Proxiderm model D 460.

Figure 3 Figure 4

Figure 3   There were 4 applications of Proxiderms. Appearance at day 7

Figure 4 Appearance at 6 months

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