Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_998_Библиотеки_им_академика_М_И_Перельмана

This is a review of use of a new wound treatment modality over a 6-year period. As the amount and formulation of the UBM-ECM device used was based on our accumulated clinical experience, there was not consistent application of the formu­lations used or the amounts placed, and new device formulations were used as they became clinically available. As such, comparisons of heal­ing rates and time to closure among these patients has little foundation, but an appreciation of the lessons learned in an attempt to establish best practice seemed warranted. Forehead and scalp wound patients as a group often needed several device applications with initial patients having alternate day powder placed and later patient have larger volumes of several formulations placed less frequently. A secondary skin graft was done in nine of these wounds. One patient in particular with a large radiated full-thickness skull wound and metastatic angiosarcoma healed poorly and died from his underlying disease with his open wound. Nasal wounds had good healing, and the forehead ap patients liked the result with a stan­dard two-stage transfer that did not need later sec­ondary thinning or revision. The ear keloid patient had some thickening of the healed ear scar return at 2 years, but the adjacent involved neck scar region appeared normal. Facial scarring wound patients showed improvements with open wounds, but the one patient with contracted old closed wounds showed little improvement in tissue for­mation or softening of the contracted skin. The two intraoral uses where the antral closure patient picked the device out of her wound and the radi­ated patient removed the bolster stent at postop­erative day 2.5 had no long-term improvement.