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Osteotomies and autografted artificial dermal substitute over bone marrow in a bone-deep burn in an elder patient: An alternative to amputation

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Abstract

In this report, we describe the case of an elder patient who suffered a third-degree fire burn with extensive bone affection and exposure of both tibias. The usual treatment strategy for this type of case would have been amputation, or the performance of a multiple free flap surgery. Notwithstanding taking into account the age and the functional objectives for this patient, the multiple free flap option was disregarded. Therefore, we performed an original limb salvage procedure which consisted in bilateral anterior tibial cortex osteotomies and direct grafting over bone marrow, applying skin grafts over a monolayer artificial dermal substitute (Integra®), covered by a negative pressure therapy device. The wound was successfully and early covered, preventing the patient from the long hospital stay and derived complications that other coverage strategies would have carried.

Level of Evidence: Level V, therapeutic study.

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Authors and Affiliations

  1. Department of Plastic Surgery and Burns, University and Polytechnic Hospital La Fe, Avinguda de Fernando Abril Martorell, 106, 46026, Valencia, Valencia, Spain

    Enrique Salmerón-González, Elena García-Vilariño, M Dolores Pérez-del-Caz, Alberto Ruiz-Cases, Pilar Corella-Estevez & Álvaro Forés-Zaragoza

Authors
  1. Enrique Salmerón-González
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  2. Elena García-Vilariño
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  3. M Dolores Pérez-del-Caz
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  4. Alberto Ruiz-Cases
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  5. Pilar Corella-Estevez
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  6. Álvaro Forés-Zaragoza
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Corresponding author

Correspondence to Enrique Salmerón-González.

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Funding

No funding was received by any of the authors of this manuscript.

Conflict of interest

Enrique Salmerón-González, Elena García-Vilariño, M Dolores Pérez-del-Caz, Alberto Ruiz-Cases, Pilar Corella-Estevez, and Álvaro Forés-Zaragoza declare that they have no conflict of interest.

Ethical approval

No ethical approval was required for the performance of the reported technique in our hospital. Consent to submit has been received explicitly from all co-authors, as well as from the head of the Burns Department of our institution.

Informed consent

Informed consent was obtained from patient’s relatives, as he died before this article had been written.

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Salmerón-González, E., García-Vilariño, E., Pérez-del-Caz, M.D. et al. Osteotomies and autografted artificial dermal substitute over bone marrow in a bone-deep burn in an elder patient: An alternative to amputation. Eur J Plast Surg 41, 471–474 (2018). https://doi.org/10.1007/s00238-018-1401-8

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  • DOI: https://doi.org/10.1007/s00238-018-1401-8

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