Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study
Background:. Complex and chronic lower extremity defects present a surgical challenge and can progress to eventual amputation if closure is not achieved. In addition to morbidity and mortality, these defects have a significant impact on patient quality of life and represent a substantial cost burden...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-12-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006406 |
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| author | John Lawlor, DPM Brandon A. Bosque, DPM Christopher Frampton, PhD D. Adam Young, PhD Patrick Martyka, DPM |
| author_facet | John Lawlor, DPM Brandon A. Bosque, DPM Christopher Frampton, PhD D. Adam Young, PhD Patrick Martyka, DPM |
| author_sort | John Lawlor, DPM |
| collection | DOAJ |
| description | Background:. Complex and chronic lower extremity defects present a surgical challenge and can progress to eventual amputation if closure is not achieved. In addition to morbidity and mortality, these defects have a significant impact on patient quality of life and represent a substantial cost burden to the healthcare system. Ovine forestomach matrix (OFM) grafts are an advanced tissue scaffold option to supplement the surgical reconstruction ladder and may augment limb preservation in cases of complex lower extremity defects.
Methods:. A prospective observational study enrolled 130 complex lower extremity reconstructions that received OFM as part of surgical management. Granulation tissue formation, defect closure, and postoperative complications were assessed up to 1 year postoperatively to evaluate the outcome of OFM grafts for limb salvage via surgical reconstruction.
Results:. Participant demographics and defect characteristics were reflective of a real-world inpatient population with complex and chronic defects. Despite complexity of the defects, no postoperative infections or major amputations were reported. The median time to complete granulation tissue coverage and fill was 30.0 days (95% confidence interval, 26.9–33.1) and the median time to complete defect closure was 127.0 days (95% confidence interval, 110.5–143.5). At 180 days, a 62% incidence of healing was achieved with a median product application of 1.0 (interquartile range, 1.0–1.0).
Conclusions:. OFM-based grafts supported successful coverage of lower extremity defects in a real-world cohort with known risk-factors for amputation. Achieving successful closure with minimal complications, and often in a single application, suggests utility of OFM as a cost-effective adjunct in lower extremity reconstruction. |
| format | Article |
| id | doaj-art-b2486109359645c78febc02a5d31141f |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-b2486109359645c78febc02a5d31141f2024-12-24T09:46:25ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-12-011212e640610.1097/GOX.0000000000006406202412000-00043Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective StudyJohn Lawlor, DPM0Brandon A. Bosque, DPM1Christopher Frampton, PhD2D. Adam Young, PhD3Patrick Martyka, DPM4From the * Department of Surgery, Associates in Medicine and Surgery, Fort Myers, FL† Department of Medical Affairs, Aroa Biosurgery Limited, Auckland, NZ‡ Department of Psychological Medicine (Christchurch), Otago University, Christchurch, New Zealand.† Department of Medical Affairs, Aroa Biosurgery Limited, Auckland, NZFrom the * Department of Surgery, Associates in Medicine and Surgery, Fort Myers, FLBackground:. Complex and chronic lower extremity defects present a surgical challenge and can progress to eventual amputation if closure is not achieved. In addition to morbidity and mortality, these defects have a significant impact on patient quality of life and represent a substantial cost burden to the healthcare system. Ovine forestomach matrix (OFM) grafts are an advanced tissue scaffold option to supplement the surgical reconstruction ladder and may augment limb preservation in cases of complex lower extremity defects. Methods:. A prospective observational study enrolled 130 complex lower extremity reconstructions that received OFM as part of surgical management. Granulation tissue formation, defect closure, and postoperative complications were assessed up to 1 year postoperatively to evaluate the outcome of OFM grafts for limb salvage via surgical reconstruction. Results:. Participant demographics and defect characteristics were reflective of a real-world inpatient population with complex and chronic defects. Despite complexity of the defects, no postoperative infections or major amputations were reported. The median time to complete granulation tissue coverage and fill was 30.0 days (95% confidence interval, 26.9–33.1) and the median time to complete defect closure was 127.0 days (95% confidence interval, 110.5–143.5). At 180 days, a 62% incidence of healing was achieved with a median product application of 1.0 (interquartile range, 1.0–1.0). Conclusions:. OFM-based grafts supported successful coverage of lower extremity defects in a real-world cohort with known risk-factors for amputation. Achieving successful closure with minimal complications, and often in a single application, suggests utility of OFM as a cost-effective adjunct in lower extremity reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006406 |
| spellingShingle | John Lawlor, DPM Brandon A. Bosque, DPM Christopher Frampton, PhD D. Adam Young, PhD Patrick Martyka, DPM Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study Plastic and Reconstructive Surgery, Global Open |
| title | Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study |
| title_full | Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study |
| title_fullStr | Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study |
| title_full_unstemmed | Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study |
| title_short | Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study |
| title_sort | limb salvage via surgical soft tissue reconstruction with ovine forestomach matrix grafts a prospective study |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006406 |
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