Acellular dermal matrix in the treatment and prevention of exposed vertical expandable prosthetic XXXX ribs.

@entity1 @entity7674 @entity3792 @entity281 @entity702 @entity85 @entity121
STUDY DESIGN: Case series. OBJECTIVE: To illustrate the use of @entity7674 ( @entity7674 ) in treatment and prevention of exposed vertical expandable prosthetic @entity702 rib (VEPTR) implants. SUMMARY OF BACKGROUND DATA: In the pediatric population with severe @entity3792 , VEPTR is an effective tool during growth for the correction of @entity85 . Prolonged VEPTR therapy can result in wound breakdown, implant exposure, and @entity281 . Treatment includes the use of prolonged antibiotics, @entity121 , and, when salvage fails, removal of the VEPTR. The use of @entity7674 in the treatment and prevention of VEPTR exposure has not been previously described. METHODS: Between January 2002 and January 2010, eight @entity1 who underwent placement of @entity7674 for the treatment and prevention of exposed VEPTR devices were identified. Their records were reviewed for diagnosis, sex, age of @entity1 at initial VEPTR placement, position of VEPTR placement, number of VEPTR expansions, wound complications, @entity7674 use, adjunct procedures, and length of wound follow-up. RESULTS: @entity7674 was used in eight @entity1 . In five @entity1 @entity7674 was used for compromised soft tissue overlying the VEPTR and threatened exposure of the hardware. In these cases, subsequent expansions occurred without incident and the wound remained stable with an average follow-up of 7.6 months. In three @entity1 , @entity7674 was used for exposed VEPTR hardware secondary to wound breakdown. Average follow-up was 3.3 months. In two of the three cases of exposed and contaminated hardware, stable soft tissue coverage was achieved and continued VEPTR therapy was achieved. One of the three cases of exposure involved infected and prominent hardware with purulence. This @entity1 failed to clear the @entity281 and required complete device removal. CONCLUSION: @entity7674 can treat and prevent exposed VEPTR, allowing subsequent VEPTR expansions and minimizing the need for muscle flap coverage and/or implant removal and replacement.
