case_images: PMC11063235_01
case_images: (A) 3 weeks post mastectomy: patient presented with chief complaint of erythema and pruritis at surgical site. (B) 7 weeks post mastectomy: patient returned with drainage and dehiscence of surgical incision. (C) 7 weeks post mastectomy: dehisced wound was debrided before NPWT treatment.
case_images: fonc-14-1371122-g001.jpg
case_images: PMC11063235_01_fonc-14-1371122-g001.jpg
case_images: f1
case_images: At the initial post-operative follow-up, incisional erythema was noted ( Figure 1A ), with no associated signs or symptoms of infection. Patient was temporarily lost to follow-up and presented 7 weeks post-operative with wound dehiscence and non-purulent, serous drainage ( Figure 1B ). The wound appeared to be poorly vascularized and was debrided down to healthy and well perfused tissues ( Figure 1C ), and a negative pressure wound therapy (NPWT) device applied.
case_images: (A) 12 weeks post mastectomy: patient developed periwound maceration secondary to NPWT. (B) 12 weeks post mastectomy/SEFM week 0: first SEFM was sutured into wound bed measuring 6 x 3 cm. (C) 14 weeks post mastectomy/SEFM week 2: SEFM was fully integrated into the wound two weeks later, which measured at 2 x 1 cm. Second SEFM was applied to wound bed.
case_images: fonc-14-1371122-g002.jpg
case_images: PMC11063235_01_fonc-14-1371122-g002.jpg
case_images: f2
case_images: The decision was made to pursue alternative wound treatment after 7 weeks of NPWT, due to extensive skin maceration secondary to NPWT dressings ( Figure 2A ), the patient's unwillingness to proceed with the treatment, and lack of availability for hyperbaric wound therapy. The wound was gently debrided, resulting in a 6 x 3 cm wound bed ( Figure 2B ). At the 2-week follow-up, the patient exhibited improvement in skin maceration and > 50% wound contraction, with the SEFM fully incorporated into the wound bed ( Figure 2C ).
case_images: (A) 16 weeks post mastectomy/SEFM week 4: wound measured at 0.5 x 0.5 cm after second SEFM application. (B) 20 weeks post mastectomy/SEFM week 8: surgical wound was fully closed by 8 weeks after the initial SEFM application. (C) 36 weeks post mastectomy/SEFM week 24: wound demonstrating complete healing with no recurrence of dehiscence at 24 weeks after SEFM application.
case_images: fonc-14-1371122-g003.jpg
case_images: PMC11063235_01_fonc-14-1371122-g003.jpg
case_images: f3
case_images: HgA1c 12), after 4 weeks, the wound was completely closed with a residual 0.5 x 0.5 cm eschar at the most medial aspect of the wound, at which point wound healing progress was sufficient, and additional SEFM applications were not warranted ( Figure 3A ). Her next two follow-up visits revealed a fully healed surgical incision at 8 weeks and 6 months, respectively, after initial SEFM treatment ( Figure 3B, C ).