(CS-170) Wound Complications and Limb Salvage Following Orthopedic Surgery Using a Full Thickness Lyophilized Amnion Chorion Membrane

Post-operative wound complications following instrumented orthopedic procedures, though relatively uncommon, can result in significant morbidity and may progress to limb loss, particularly in elderly patients with multiple comorbidities. Biologic adjuncts such as full thickness lyophilized amnion-chorion membranes (LACM) have gained attention for their ability to modulate inflammation, enhance granulation, and support closure in complex surgical wounds. This case describes limb salvage in an 82-year-old male with extensive cardiovascular, metabolic, and renal disease who developed deep infection and wound dehiscence after sequential hip and tibial fracture repair.


Methods:

The patient initially presented with a left intertrochanteric hip fracture and was treated with open cephalomedullary nail fixation. Six months later, a second high-impact fall caused a comminuted left tibial fracture, surgically fixed with intramedullary nailing. Patient returned with surgical wound dehiscence and deep infection along the tibial incision. Operative debridement, irrigation, and removal of the intramedullary nail were performed, followed by application of negative pressure wound therapy (NPWT). Biweekly LACM applications were started in an outpatient setting and wound area, drainage, granulation quality, and infection status were assessed at each visit.


Results:

Use of LACM produced progressive granulation and steady wound contraction of the tibial defect. Full closure occurred approximately three months after initiating LACM therapy. No recurrence of infection was documented at the tibial site following introduction of LACM. Limb amputation, previously considered due to the severity of the complication, was ultimately avoided.


Discussion:

Use of LACM produced progressive granulation and steady wound contraction of the tibial defect. Full closure occurred approximately three months after initiating LACM therapy. No recurrence of infection was documented at the tibial site following introduction of LACM. Limb amputation, previously considered due to the severity of the complication, was ultimately avoided.