Acellular bovine-derived matrix used on a traumatic crush injury of the hand: a case study

Wound care options that provide quality care at a reasonable cost are integral to limb salvage and everyday treatment approaches in patients with traumatic injuries and nonhealing, chronic wounds. Human skin substitutes, or bioengineered tissues, have been available for many years but data about the use, safety, and effectiveness of bovine-derived bioengineered products are limited. A 50-year old man was seen at the wound clinic with a failing skin graft 65 days after sustaining a crush injury of his dominant hand. Following the injury, the patient underwent amputation of the ring and little finger, a revascularization procedure, and an open reduction and internal fixation of the right thumb and long finger. Following debridement, two applications of bovine-derived bioengineered tissue resulted in wound closure, limb preservation, and maximum functional use. Use of hydrogel-soaked and petrolatum-impregnated gauze as secondary and tertiary dressings, respectively, was needed to help maintain optimal bioengineered tissue moisture levels. Additional clinical studies to assess the use, safety, and cost effectiveness of this treatment modality are warranted.