Patient History
A 24 year old male sustained a severe work-related injury that resulted in acute compartment syndrome requiring both forearm and hand fasciotomies. The injury created extensive dorsal and volar soft tissue defects involving the forearm, wrist, and thumb that required staged surgical management.
Treatment
In the operating room, fascial incisions were made to alleviate pressure. During the debridement phase, Restrata was applied to the lateral aspect of the wrist to provide coverage over the unprotected ulnar neurovascular bundle, which could not be covered with local fascia or muscle. The remainder of the incisions were left open to prevent pressure build up.
Seven days later, Restrata Sheet , Meshed, and MiniMatrix® were applied to both dorsal/ventral forearm, wrist and the thenar eminence. On Day 14 (Week 2) the patient returned to the OR due to bleeding. In order to control the bleeding, the Restrata Sheet needed to be removed from the volar forearm aspect. After the bleeding was controlled, MiniMatrix was applied to the defect followed by negative pressure wound therapy (NPWT).
By Week 4, a healthy granulation base was present.