Grade IIIA Open Tibial Fracture Following Motor Vehicle Crash

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Patient History

Patient is a 23-year-old female who presented to the emergency department following a motor vehicle crash (MVC). Patient underwent an index surgery for implantation of an intermedullary (IM) nail through the tibia to stabilize a grade IIIA open tibial fracture.

Treatment

Patient experienced complications following the index surgery by way of failed conservative wound care. The patient was taken to the operating room (OR) for hydrosurgical debridement to ensure any necrotic/infected tissue was removed.* Restrata Sheet was applied at time of debridement and gradually resorbed over the course of the first two weeks. As Restrata integrated into the surgical defect, a granulation base began to form. A second sheet of Restrata was applied to the surgical defect at week three. The healing progression continued throughout Restrata applications.

Conclusion

Three weeks following the second Restrata application, a healthy bed of granulation tissue formed throughout the soft-tissue defect. A gradual healing progression was observed and the defect reached full closure via secondary intention. No complications were noted throughout the healing process.

A) Grade IIIA open tibial fracture B) Carbon fiber IM nail implant C) HEALED Full weight bearing, no signs of infection

WEEK 0

Initial Restrata Sheet application

WEEK 1

Restrata beginning to integrate into wound bed

WEEK 2

Second application of Restrata applied at week 3

WEEK 4

One week following 2nd Restrata Sheet application

WEEK 5

Granulation tissue developing as Restrata continues to resorb

WEEK 6

WEEK 12

Restrata fully integrated

WEEK 28

Fully healed

*Infection was controlled and no longer present at the time of the initial Restrata application.

Restrata has not been studied in wounds that extend into the tendon, muscle, joint capsule, or bone. Restrata should not be applied until excessive exudate, bleeding, acute swelling, and infection is controlled. Please refer to the Instructions for Use for a full list of indications, contraindications, precautions, and warnings.

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