Use of a Bioresorbable Silver Matrix on a Four-Year-Old Recalcitrant Trauma Wound

Background: A 53-year-old female patient in dire need of a total knee replacement presented with a chronic ankle wound that was open for 4 years. Because open wounds are contraindicated for elective surgery, closing her wound took precedence. On initial evaluation, the patient reported she had sustained severe injuries to her lower left extremity in a motor vehicle accident. The wound over the left medial ankle occurred secondary to extensive surgery to repair fractures of the left lower extremity.

The patient’s post-op wound then, unfortunately, became recalcitrant. The patient reported that the wound is painless and only complained of pain in the right knee secondary to end stage osteoarthritis. The patient is retired and assists her elderly parents with activities of daily living, therefore getting her wound healed as quickly as possible was a top priority. A bioresorbable silver matrix (Microfilm Matrix)* was used to provide a template to support reepithelialization and manage bioburden.

Methods: Initial wound care consisted of Iodosorb and therahoney applied weekly until week 2. At week 3, the wound was debrided with sharp debridement and Microfilm Matrix was applied weekly for 4 weeks. Two-layer compression was used as the secondary layer, and wound was off-loaded with felt outside of the compression.

Results: Two weeks after conservative wound treatment, the patient's wound remained unchanged. However, after just 1 week off Microfilm Matrix treatment, the patient's wound dramatically decreased by 97%, and by week 6, the wound is almost fully reepithelialized at 98%. Importantly, patient is now scheduled for total knee replacement surgery by her orthopedic surgeon.

Conclusions; After just 4 applications of Microfilm Matrix over 6 weeks, the patient’s wound is almost completely reepithelialized, and importantly, she can now proceed with orthopedic surgery. Of note, the patient would have been referred to plastic surgery if her wound did not close in a timely manner; the Microfilm Matrix played a large role in preventing this outcome. Furthermore, Microfilm Matrix application was painless, comfortable, and easy to use.