Francis Derk1, Mike Griffiths2

1South Texas VA Medical Center (San Antonio, United States) 2AOTI (Oceanside, United States)

A 66 yr/o Male with a hx of severe PVD, CVA, CHF, Hep C, s/p BKA, End Stage Renal Dx, and DM.

Underwent a TMA of the Left foot secondary to Osteomyelitis and infection.

Vascular Assessment: ABIs: Left Not

compressible (N/C) TBIs: (TMA)

S/P: SFA-PTA Bypass Non palpable pulses

Dopplers: non audible Waveforms: flat line

Smoker: History of

Smoking 1 PPD / 35 yr

Pack hx

Topical Wound Oxygen Therapy System

The patient was placed on Topical Wound Oxygen Therapy for wound staging and wound bed preparation.

The patient underwent a Vascular Bypass Graft 5 months prior to the TMA procedure.

Pre and Post NIs were N/C.

The patient was not a candidate for further vascular surgery and presented with a natural hx of limb loss on the contralateral side prior secondary to PVD and infection.

Left TMA: Immediately Post op

Immediately post operatively, the wound became escharotic and

dehisced

Mesenchymal Stem Cell Living Skin Substitute

Preparation

Application of Mesenchymal

Stem Cell Living Skin Substitute

Application of Steri Strips

Wound Measurement 7.5

x 2.8 cm

5 Weeks and 2 applications of Mesenchymal Stem Cell Living Skin Substitute (4weeks) The

Patient continued with Topical Wound Oxygen

Therapy until full healing

5 Weeks of Topical Wound Oxygen Therapy Therapy 45

min/BID

Topical Wound Oxygen Therapy was very effective in wound bed preparation and achieving rapid closure when used in combination with Mesenchymal Stem Cell Living Skin Substitute

Time of Healing

X-rays Blood Cultures

Lab Analysis

9 Weeks Negative negative WBC /CPR/Sed rate WNL