Abstract:

Chronic wounds with exposed bone present a challenge for clinicians. Without intact periosteum, cortical bone is relatively avascular and provides a poor base for wound healing and skin grafting. It has been shown that cortical bone fenestration and decortication can expedite wound healing in exposed calvarial bone. We present a case study where cortical bone fenestration and the subsequent application of human skin equivalent were used to heal a chronic wound of the lower extremity. We propose that this technique can facilitate the production of granulation tissue, and can aid the healing of chronic wounds of the lower extremities associated with exposed bone.

Authors:

Wayne J. Caputo, D.P.M., F.A.C.F.A.S., Director, Wound Care Center, Department Chair, Division of Podiatric Surgery, Clara Maass Medical Center, Belleville, New Jersey, Director, Department of Podiatry, Columbus Hospital, Newark, New Jersey, USA; Charles D. Ganime, D.P.M., F.A.C.F.A.S., Private Practice, Winchester, Tennessee, USA; George Fahoury, D.P.M., F.A.C.F.A.S., Department Chair, Division of Podiatric Surgery, Monmouth Medical Center, Monmouth, New Jersey, USA; Stephen Longobardi, M.B.A., D.P.M., Private Practice, Union, New Jersey, USA

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