This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kopp, J. Articles by Horch, R. E. Search for Related Content PubMed PubMed Citation Articles by Kopp, J. Articles by Horch, R. E. Social Bookmarking                         What's this?

Buried Chip Skin Grafting in Neuropathic Diabetic Foot Ulcers Following Vacuum-Assisted Wound Bed Preparation: Enhancing a Classic Surgical Tool with Novel Technologies

Department of Plastic and Hand Surgery, University Medical Center, Friedrich-Alexander-University Erlangen-Nürnberg, Germany, juergen.kopp{at}chir.imed.uni-erlangen.de

Ulrich Kneser, MD

Department of Plastic and Hand Surgery, University Medical Center, Friedrich-Alexander-University Erlangen-Nürnberg, Germany

Alexander D. Bach, MD

Department of Plastic and Hand Surgery, University Medical Center, Friedrich-Alexander-University Erlangen-Nürnberg, Germany

Raymund E. Horch, MD, PhD

Department of Plastic and Hand Surgery, University Medical Center, Friedrich-Alexander-University Erlangen-Nürnberg, Germany

In patients with diabetes mellitus, complications such as polyneuropathy and peripheral angiopathy inevitably lead to diabetic foot complications including foot ulcers, gangrene, and osteoarthropathy. These conditions necessitate minor or major amputation as part of treatment. In patients with Charcot’s arthropathy and predominant neuropathy, recurrent foot ulcers are common in areas of high pressure. Such high pressure is caused by the degrading of the architecture of the foot and inadequate footwear. These patients are a clinical challenge. A select group of such patients may benefit from free surgical tissue transfer, though free or local flap surgery is often difficult or even impossible owing to an impaired arterial circulation. In such wounds, surgical debridement followed by skin grafts often fail due to bacterial burden in the wounds. To circumvent these problems, the authors developed a therapeutic approach using buried chip skin grafting to close granulation wound beds in diabetic feet. Locally applied vacuum therapy (VAC®) for wound bed preparation of chronic, nonresponsive foot ulcers and subsequent grafting using the burying technique with a minute fraction of skin was used. Firm closure was achieved. The closed wound was resistant to mechanical irritation.

Key Words: diabetic foot ulcer • vacuum therapy • buried chip skin grafting

The International Journal of Lower Extremity Wounds, Vol. 3, No. 3, 168-171 (2004)
DOI: 10.1177/1534734604268092


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?