The costs and outcomes of treating a deep pressure ulcer in a patient with quadriplegia .

 The cost of pressure ulcers, especially Stage III and Stage IV ulcers, is substantial. A 27-year-old man with a 6-year history of quadriplegia developed an ischial pressure ulcer. Twelve months of treatment with wet-to-dry dressings were followed by admission to several facilities and 15 months of care with biological dressings and negative pressure wound therapy (NPWT).

Closure of difficult wounds by external tissue expansion.

 The open nonhealing wound is a persistent challenge to physicians. Infections, foreign bodies, osteomyelitis, and skin coverage of repaired structures remain problems. As the body ages, the elderly are prone to the development of pressure sores and foot ulcers, particularly patients with diabetes.

Prevention of major amputations in nonischemic lower limb lesions.

Background: Major lower limb amputations continue to be performed at an increasing rate, the major cause being the rising prevalence of adult onset diabetes. It can be demonstrated that a reduction in amputation rate can be achieved at institutes with a higher level of academic and specialty interest, by avoiding errors of management and by newer technical innovations in wound closure.

Study Design: A simpler method of wound closure that is easily taught and learned and is readily available to the medical community and the patient population can play a substantial role in reducing the number of amputations.

The management of the postoperative disrupted abdominal wall.

Background: Dehisced abdominal wounds are common. Their management is generally difficult and often prolonged, with incisional hernias a common occurrence. A new technique is presented that results in accelerated delayed primary healing with full thickness skin and subcutaneous tissue coverage.