The authors present the use of Integra in a unique cohort of patients. Seven patients ages 21-31 in a six month period treated in one hospital. These were a very fit group of patients that had injuries caused by improvised explosive devices and had limb and trunk injuries. With better medical evacuation and field services, more service personnel survive injuries that were fatal previously. Unfortunately, when first evacuated they have significant injuries apart from the massive soft tissue injuries. There is a relative lack of skin that can be used to close open wounds / amputation. These patients, whilst previously very fit, are now unable to undergo the complex surgery. This is in distinction to the more commonly encountered vascular patient with compromised physiology and motivation. The authors describe the use of IntegraTM for early closure of the defects. Seven patients with 11 wounds were treated. Good take was noted in eight wounds and there was only one complete loss. Partial take was noted in two wounds. While this is a small number of patients, anything that helps in the treatment of this unique cohort of patients and these injuries in useful. There is also an introduction to this type of war injury and difficulty in treating it.

IntegraTM permits early durable coverage of improvised explosive device (IED) amputation stumps.
Foong DPS, Evriviades D, Jeffery SLA.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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