Novel use of biodegradable temporising matrix for non-healing wounds following non-medical grade silicone injectionables.

Abstract

Silicone injections are frequently used for aesthetic purposes, demonstrating safety when administered by ethical licensed medical professionals using medical-grade silicone. However, when non-medical-grade silicone is used for injections, complications can arise, such as silicone migration, cellulitis, silicone nodules, granulomatous formations and chronic open wounds. These wounds can be disfiguring and extremely difficult to treat. In this article, we present the case of a late 30-year-old male-to-female transgender patient who underwent non-medical-grade silicone injections in Mexico 20 years ago. These injections targeted her buttocks, bilateral hips and bilateral thighs, which resulted in significant silicone migration and large non-healing wounds. The total size of the wounds was 130 cm² on the left thigh, 280.8 cm² on the right buttocks, and 287.5 cm² on the right thigh before surgical intervention. To achieve definitive wound closure, we used a novel biodegradable temporising matrix to cover and integrate into the wounds. Single-stage grafting over the tissue was challenging due to the silicone present in all of the tissue. Therefore, we used this novel matrix to build a suitable bed for subsequent skin grafting. This method yielded favourable surgical and aesthetic results.