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Case Series/Study
Traumatic injuries with extensive tissue loss pose a significant challenge for wound healing. Because these types of injuries can be associated with bone and tendon exposure or vascular and nerve injury, often a combination of advanced repair materials is needed.
Methods:
Here, we present the case of a young patient who benefited from the application of polylactic (PLA) matrices in traumatic wounds.
Results: A 31-year-old male presented with a traumatic wound on the volar aspect of the left wrist, another on the medial left knee, and a third on the right hand. The wounds had significant tissue loss, so they were treated with fish skin xenografts after extensive debridement of the compromised tissue. This approach led to temporizing the wound bed, which was filled with granulation tissue. However, because of their sizes, epithelization did not occur. Additionally, the patient complained of significant pain in his wounds. To promote the epithelization of the defects, the wounds were switched to PLA closure matrices. Within the first 3 days, the patient reported significant pain reduction, with it even completely disappearing on the knee wound. The wounds on the knee and right hand healed after 2 weeks of treatment, and the one on the left wrist experienced a significant reduction in size after 3 weeks of treatment. The use of PLA matrices induced thick epithelial borders that closed the wounds by secondary intention with minimal scarring.
Discussion:
PLA is a fully synthetic skin substitute that exerts powerful angiogenic and immunomodulatory effects and enables keratinocytes to migrate faster, thus achieving the epithelization of large wound areas. PLA matrices have long been used in burn victims due to these effects and recently have been started to be applied to traumatic and chronic wounds. This case illustrates two of its main benefits, first, the complete closure of wounds where other treatment strategies have been used to temporize a wound bed, and second, a significant reduction in pain after their application due to immunoregulation of the wound bed and the restoration of the local pH values to physiological ones.
Trademarked Items: SupraSDRM
References: 1. Mirhaj M, Labbaf S, Tavakoli M, Seifalian AM. Emerging treatment strategies in wound care. Int Wound J. 2022 Nov;19(7):1934–54.
2. Ring A, Goertz O, Al-Benna S, Ottomann C, Langer S, Steinstraesser L, et al. Accelerated angiogenic induction and vascular integration in a novel synthetic scaffolding matrix for tissue replacement. Int J Artif Organs. 2010 Dec;33(12):877–84.
3. Haller HL, Sander F, Popp D, Rapp M, Hartmann B, Demircan M, et al. Oxygen, pH, Lactate, and Metabolism—How Old Knowledge and New Insights Might Be Combined for New Wound Treatment. Medicina. 2021 Nov;57(11):1190.