Henderson JA, Jones MW, Houle SS, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2019 Mar 1;volume 31(3):E18-E20.
1. Wounds. 2019 Mar;31(3):E18-E20.
Innovative Use of dHACM in Conjunction With Hyperbaric Oxygen Therapy to Treat a
Nonhealing Nasal Wound Subsequent to Squamous Cell Carcinoma Resection and
Radiation: A Case Study.
Henderson JA(1), Jones MW(1), Houle SS(1).
Author information:
(1)McLaren Greater Lansing Wound Care and Hyperbaric Center, Lansing, MI.
INTRODUCTION: Hyperbaric oxygen therapy is known to improve wound healing in the
setting of chronic, nonhealing wounds of irradiated skin; however, failure of
wound healing may still occur. Dehydrated human amnion/chorion membrane (dHACM)
grafting is a technology that has been proven to promote wound healing of wounds
related to venous stasis. Little has been published to date regarding use of
dHACM in the setting of nonhealing wounds of irradiated skin.
CASE REPORT: A 75-year-old man with a history of squamous cell carcinoma of the
nose presented to the wound clinic with a chronic, nonhealing nasal wound
following tumor resection, radiation therapy, and full-thickness skin graft and
auricular cartilage allograft failure. The patient was found to have a nasal
cutaneous fistula associated with rhinorrhea, adjacent skin irritation, and
discomfort related to the passage of air through the fistulous tract. Following
30 days of standard wound care in the wound clinic (including weekly
debridement), the patient continued to have an open, nonhealing wound. As he
preferred not to proceed with a surgical flap reconstruction, the patient
elected to continue with more conservative management. Hyperbaric oxygen therapy
was initiated with some success but with continued presence of a nonhealing
fistula tract. A dHACM graft then was applied with successful resolution of the
patient's symptoms and decrease in defect size of 45% after 4 applications.
CONCLUSIONS: This treatment approach ultimately resulted in complete
reepithelization of the wound, and a decrease in defect area. The patient's
symptoms of nasal drainage and physical discomfort due to air passage through
the fistula also had resolved completely. Although the fistula was still present
at the conclusion of treatment, the tract was well-epithelialized and overall
size of the defect diminished greatly.
PMID: 30924794 [Indexed for MEDLINE]
Appears in following Topics:
