Volume 29, Issue 163, September 2025

Case description: Complex treatment of chronic breast wounds using intermediate thickness skin grafts and supportive therapies

Julia Nosko^♦, Adrianna Truszyńska-Zawisza, Natalia Sioch, Julia Krotofil, Wojciech Jasek

Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland

^♦Corresponding author
Julia Nosko, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland

ABSTRACT

Medium-thickness grafts are a prevalent treatment for a multitude of conditions, including chronic wounds, ulcers, and burn wounds. They are also widely used in reconstructive surgery. This paper describes the case of a 29-year-old female patient treated at the Clinical Department of Plastic, Reconstructive, and Burn Surgery with a chronic wound, who was qualified for a split-thickness skin graft, which was unsuccessful on the first attempt. Prior to the subsequent attempt at wound closure, the team conducts microbiological verification of the wound bed. Consequently, the wound swab culture revealed the presence of pathogens, thus confirming the necessity for targeted antibiotic therapy. This therapy was initiated with the aim of preparing the wound bed for another attempt at closure. In the operating theatre, the wound was debrided of necrotic and adipose tissue, after which a negative pressure dressing was placed. The procedure was subject to modification on a twoto- three-day basis, with the maintenance phase lasting 7 days in total, with a view to stimulating granulation. A further intermediate-thickness skin graft was applied to the prepared chronic wound bed. However, complete healing of the graft was not achieved after a period of 10 days. Then we applied a matrix dressing. This was followed by the secondary phase, which entailed wound closure. Only after such treatment was complete healing achieved. In this article, we present a multidisciplinary approach to the treatment of chronic wounds. Proper wound bed preparation is important. The intermediate thickness skin graft should be used accordingly. Microbiological examination of the wound is also helpful. Additionally, it highlights the employment of alternative supportive methods in instances of partial graft non-healing.

Keywords: graft, intermediate thickness skin graft, chronic wound, VAC therapy, collagen matrix

Medical Science, 2025, 29, e162ms3700

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DOI: https://doi.org/10.54905/disssi.v29i163.e162ms3700

Published: 14 September 2025