(CS-056) Innovative Use of Bordered Silicone Foam for Post-Graft Management in Complex Foot Wounds: A Case Series

Jamie Moore, AGNP-C, MSN, WCS-C, EDS-C, CWCP, CFCS

Introduction: Postoperative graft success in the foot and ankle is often limited by challenges in dressing performance, particularly in high-motion, high-exudate environments. Traditional dry sterile dressings frequently require frequent changes, risk maceration, and struggle to maintain stable wound contact, which may compromise graft adherence and healing. Rural patients face additional barriers when complex, multilayer dressings demand frequent home-health support. This case series was designed to evaluate whether Bordered Silicone Foam could address these limitations by providing more consistent moisture control, dressing stability, and graft protection than conventional dressings.

Methods: This comparative case series included eight patients with complex foot wounds requiring biologic grafting. All underwent operative debridement, placement of antibiotic-loaded resorbable cement, and application of amniotic and dermal  grafts secured with staples. A silber impregnanted non-adherent contact layer was applied before postoperative dressing assignment. Four patients received standard dry sterile dressings, and four received bordered silicone foam dressings. All patients were uniformly offloaded and followed weekly for six weeks. Outcomes included dressing-change frequency, periwound maceration, dressing stability, graft integrity, and signs of infection.

 

Results: Eight patients completed the six-week follow-up. The bordered silicone foam dressing group required fewer dressing changes (0.63 vs. 1.54 per week), reflecting improved stability and reduced strike-through. Periwound maceration occurred once in the bordred foam silicone dressing group compared with four instances in the SOC group. One bordered silicone foam patient experienced partial graft-edge lift requiring staple reinforcement. Localized infections occurred in one bordered silicone foam dressing patient and two SOC patients, all resolving with oral antibiotics. No graft failures, systemic complications, or amputations occurred. Overall, bordred foam silicone dressings demonstrated favorable trends in moisture control and dressing performance.

Discussion: Bordered silicone foam dressings demonstrated postoperative advantages over traditional dry sterile dressings, including fewer dressing changes, reduced maceration, and improved moisture control. These factors likely contributed to greater dressing stability, which is essential for protecting biologic grafts in high-motion foot environments. Although one bordered silicone foam dressing case experienced graft-edge lift, this appeared patient-specific rather than dressing-related. Infection rates were low in both groups but occurred twice as often in the SOC cohort. While limited by small sample size, these trends suggest bordered silicone foam dressings perform at least as well as, and may outperform, traditional dressings in graft management.