At the Orthopedic Foot & Ankle Center, I had the opportunity to be the first in Ohio to use a “Minced” skin autograft for the coverage of chronic wounds. This exciting technique has several advantages over a split thickness skin graft in certain situations. Split thickness skin grafts are usually expanded no more than six times with a maximum of nine times. With a minced skin technique, we’re able to expand the skin autograft up to 100 times, enabling us to effectively to cover much larger wound areas with less donor skin.

THE FOLLOWING PHOTOGRAPHS GIVE YOU A GLIMPSE INTO THE MINCED SKIN AUTOGRAFT TECHNIQUE.

A single-use disposable kit with dermatome and mincer.

The wound bed is prepared in the typical fashion to receive the graft.

The graft is taken with the non-powered dermatome.

The donor site after the graft is taken.

The autograft skin placed on the back table.

The autograft skin is then minced into pieces 0.8mm X 0.8mm.

The minced skin ready to be grafted.

The graft is then inserted into the wound and covered with a non-adherent dressing.

Using this new technique, we’re now able to cover acute and chronic wounds as well as burns while using minimal donor tissue.  We’ll be following this patient and carefully watching his progress. I encourage you to check back often to see the benefits of this technique in treating chronic wounds.

I’ve always wanted to be on the forefront of medical technology and perform the latest procedures – that’s what inspired me to be a surgeon. At OFAC, that’s exactly what I’m able to do every day. I’m glad I can help more patients with the minced skin autograft technique, and I look forward to even more advancements.

Will DeCarbo, DPM, AACFAS – Fellowship Trained Foot & Ankle Surgeon

NOTRE DAME’S JIMMY CLAUSEN SUSTAINED THIS KIND OF INJURY EARLIER THIS FALL.

Turf toe injuries are graded based on the amount tearing (partial or complete) to the joint lining and ligaments as well as the degree of associated bone injury. Afflicted athletes may have difficulty with acceleration, change of direction, and jumping. Most players will recover in one to three months with rest, taping, anti-inflammatory medication, physical therapy and custom inserts. Fortunately, only the most severe turf toe injuries require surgery.

If you experience a turf toe injury that results in difficulty walking, pain with motion of the joint, and doesn’t improve with rest, schedule an exam with your local foot and ankle expert. An MRI will help determine the severity of your injury and the required treatment.

Take a look at this video featuring a local athlete and his turf toe injury experience.

For more in-depth information, you can check out the Turf Toe chapter we contributed to the new book, Foot and Ankle Surgery Operative Techniques.

With the weather getting cooler and the fall sports seasons starting, there are a lot more injuries. Confusion remains over sprains, strains, and contusions. Excellent resources for these injuries can be found on the internet.

The bottom line is this: if you get injuried, immediately rest and immobilize, ice, compress, and elevate (RICE). Perhaps the most important is to immobilize. As a boy scout (or girl scout) we all recall using a rolled up magazine to splint a sprain. Pain arises as the injured tissues continue to be exposed to movement. By immobilizing a limb, the injured flesh is allowed to rest and begin healing.

Ice, compression, and elevation all help with the swelling but the immobilization is the only intervention that actually begins to help with healing. Contrary to what your buddies may say, dont try to walk it off. It may aggravate the injury.

If the pain is severe or its not improved with time, always seek medical opinion. Urgent care centers, emergency rooms, or a quick phone call to your primary care physician is never wasted time.

95% of all sprains and strains heal without any specialized treatment.

Sprains and strains always involve soft tissue structures such as ligaments or tendons. Contusions generally involve an impact injury and involve bruising of fleshy tissue and in severe cases involve bone bruises.

If the injury hasn’t resolved in a week, medical attention is definitely important. At this point, specialized immobilization may be required. Physical therapy may be required. X-rays at this time are important. Though unusual, there can be subtle fractures, broken bones, or even hairline stress fractures.

With modern advances, the rare 5% that do not heal now have opportunities for advanced sports medicine techniques. Ankle arthroscopy can heal ligaments through small minor punctures in the skin. Lasers and more advanced thermal probes can literally weld ligaments together. What used to take almost a year of recovery can now be repaired in just a few short weeks.

But the most critical time period is the first day after the injury. Remember, Rest and immobilize, Ice, Compress, and Elevate. RICE.