The use of negative pressure therapy and hyaluronic acid for the management of post-traumatic lower limb injury

Abstract

Management of severe limb trauma continues to challenge surgeons. Suitable treatment should be individualised for each patient, taking into consideration not only the wound extremity but also the associated injuries, age and socioeconomic status of the patient with the goal to recover function and to improve patient quality of life. The aim of this report is to present a severe degloving multiplane lower limb injury case in which a conservative treatment of the wound was performed with negative pressure therapy and dermal substitute, avoiding amputation and restoring limb function.

Keywords: Advanced dressings; Conservative treatment; Degloving injuries; Dermal substitute; Negative pressure therapy.

Figure 1

(A) Pre‐operative appearance of the severe soft‐tissue injuries with black necrosis due to complete degloving of the skin and soft tissue on the right lower limb at the Emergency Department. (B) Large wound after surgical debridement and negative therapy pressure. (C) Dermal substitute application. (D) At 3 months post injury after conservative treatment the wound of the lower leg is completely closed.

Figure 2

At 6‐month follow‐up the flexion–extension movements are maintained and the patient ambulates independently. (A) Magnified view of the leg. (B) Lateral view. (C) Frontal view. (D) Maintainance of the flexion‐extension movements.