Managing wounds with exposed tendon and bone.

W ounds with exposed tendon and bone present a challenging problem for the wound care surgeon. Ideally, the tendon or bone should be free of infection and necrosis; therefore, debridement is necessary before additional procedures a re perform ed . Al s o, ti s sues must be adequ a tely hydrated to avoid desiccation and to preserve the viability of the tendon and peritenon. Desiccation can lead to tissue death, infection, loss of tendon function, and possible pathological rupture. We em p l oy a va ri ety of produ cts wh en ad d re s s i n g wounds with ten don and bone ex po su re . All ografts and xen ogra f t s , a l ong with ro t a ti onal and free flaps,can be util i zed for bi o l ogical covera ge . We of ten use conven ti on a l f rozen cad averic skin and xen ogra phic materials su ch as Pri m a tri x (TEI Bi o s c i en ces Inc.) and Graft Jacket a n d Graft Jacket Ex pre s s (Wri ght Medical Tech n o l ogy) for deep ti s sue space , of ten in con ju n cti on with Osteo Med ’s O s teo Set be ads (Wri ght Medical Tech n o l ogy) impregn a ted with anti bi o tics su ch as va n comyc i n . These materi a l s c re a te a scaffold or matrix to fac i l i t a te ti s sue integra ti on and gra nu l a ti on and to en h a n ce fe a s i bi l i ty of o t h er wound covera ge opti ons that can com p l ete the healing proce s s . O n ce gra nu l a ti on ti s sue is pre s en t , a uto l ogo u s s p l i t t h i ckness skin grafts or re a pp l i c a ti ons of xen ogra f t s of ten are perform ed to ach i eve com p l ete cl o su re . OW M Managing Wounds with Exposed Tendon and Bone