This is a clinical case using hADM to close an open wound of the right foot caused by the penetration of part of a shell into the skin followed by necrotizing fasciitis, after multiple unsuccessful treatments using Negative Pressure Wound Therapy, porcine acellular dermal substitutes and a split-thickness skin graft.
Skin and soft-tissue infections (SSTIs) include a variety of pathological conditions which involve the skin and underlying subcutaneous tissues, fascia or muscles, that may also cause necrotizing infections. Uncomplicated SSTIs are represented by superficial infections as furuncles, abscesses, cellulitis and/or impetigo requiring antibiotic or surgical procedures, whereas complicated SSTIs are represented by deep soft tissue infections such as necrotizing infections, infected ulcers, infected burn and major abscess requiring surgical intervention with drainage and debridement.
We report a clinical case using hADM to close an open wound of the right foot caused by the penetration of part of a shell into the skin followed by necrotizing fasciitis, after multiple unsuccessful treatments using Negative Pressure Wound Therapy, porcine acellular dermal substitutes and a split-thickness skin graft. hADM appeared to be an appropriate adjunct for wound healing process in our patient with chronic open wound failing to heal.
The use of human Acellular Dermal Matrices (hADMs) has been reported mainly after skin burns or cosmetic and reconstructive procedures. These applications can be performed successfully since hADMs have the ability to incorporate into host tissue and allow cellular and vascular ingrowths, without eliciting any biologic inflammatory response and avoiding infection.
Sergio Mazzei, Alessandro Sindoni, Fausto Famà, Giampietro Bertasi, Nimfa J Buizon and Mohab A Shafei. Glob Surg, 2019 Volume 5: 1-3.