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A case of lower-extremity deep burn wounds with periosteal necrosis successfully treated by use of allogenic cultured dermal substitute

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Abstract

In patients with burns, bone exposure accompanies serious problems which occasionally lead to amputation. We present a case of an 82-year-old woman who sustained 22% of total body surface area flame burns on her bilateral lower extremities with bone exposure. Despite fascial excision and mesh skin graft, muscles, bones, and tendons were widely exposed on her right leg. The wound was infected by methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. To promote wound healing, we applied an allogeneic cultured dermal substitute (CDS) to the wound surface once weekly, resulting in healthy granulation except for the exposed bone area of the right anterior tibia. We then shaved the cortex of the exposed bone surface until bone marrow bleeding, and grafted mesh skin in combination with CDS. Finally, all wounds healed without osteomyelitis. The use of CDS to treat deep burns exposing bone surface may expand reconstructive options for extremities that otherwise might have been amputated.

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Acknowledgments

This study was approved by the Ethics Committee of Hiroshima University. This work was supported by a grant from the Regenerating Medical Millennium Project of the Ministry of Health, Labor and Welfare. The allogeneic cultured dermal substitutes were prepared at the R&D Center for Artificial Skin of Kitasato University, Kanagawa, Japan.

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None.

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Author notes

  1. Naoki Ohara

    Present address: Department of Dermatology, Shobara Red Cross Hospital, 2-7-10 Nishihon-machi, Shobara, 727-0013, Japan

Authors and Affiliations

  1. Programs for Biomedical Research, Division of Molecular Medical Science, Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Naoki Ohara, Shoji Mihara, Hiroyuki Nihara, Narihiro Akimoto, Naoki Madokoro, Mikio Kawai, Hideki Noda & Michihiro Hide

  2. R&D Center for Artificial Skin, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan

    Yasuhiro Matsumoto & Yoshimitsu Kuroyanagi

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  1. Naoki Ohara
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  2. Shoji Mihara
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  10. Yoshimitsu Kuroyanagi
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Correspondence to Naoki Ohara.

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Ohara, N., Mihara, S., Nihara, H. et al. A case of lower-extremity deep burn wounds with periosteal necrosis successfully treated by use of allogenic cultured dermal substitute. J Artif Organs 13, 101–105 (2010). https://doi.org/10.1007/s10047-010-0499-7

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  • DOI: https://doi.org/10.1007/s10047-010-0499-7

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