Autologous

Wound Closure

The goal of caring for any wound is wound closure. The gold standard is to close the wound with autologous tissue, the tissue from the same individual harboring the wound. For chronic wounds, historically the autologous wound closure was in the form of split-thickness skin grafts containing both epidermis and dermis. To obtain such closure most often required a trip to the operating room and a painful donor site. Xpansion® micro-autografting has provided a technique to close the wound in the Wound Clinic with a split-thickness skin graft while minimizing the size of the donor site by allowing expansion of the graft up to 1:100.

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HOW TO USE XPANSION

Micro-autografing Kit?

  • Secure nonadherent dressing to wound with Steri-Strips™.
  • Maintain a moist environment (e.g., hydrogel or moisture-holding dressing).
  • Splint or immobilize if in mobile area.
  • Outer dressing can be changed at 5-7 days leaving contact layer intact.
  • Vashe irrigation and/or soak can be used at dressing changes.
  • Contact dressing can be gently teased off graft at 10-14 days using saline irrigation to prevent any dressing adherence.

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Successful

Wound Bed Prep

The key to success in any skin grafting procedure is proper wound bed preparation. All necrotic tissue must be removed from the wound. Debris, slough, bacteria, and deleterious cytokines also need to be removed. Irrigation and soaking the wound with Vashe® Wound Solution softens and helps to further debride the wound. Application of Drawtex® Hydroconductive Dressing will draw off the remaining deterrents to healing and leave the wound bed prepared to accept the micro-autografts.

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Case Study Results

  • Five-month long-term follow-up of micro-autografted wound (left) and donor site (right).

  • Five-month long-term follow-up of micro-autografted wound (left) and donor site (right).

  • Six-week follow-up of micro-autografted wound (left) and donor site (right).

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