Soft tissue grafting in healing chronic wounds: Two case studies.

Abstract

Background: A chronic wound occurs when it fails to heal resulting in a prolonged wound healing process. Traumatic and surgically induced wounds that do not heal as expected can be included in the term chronic wound. There is limited information about the management of this type of wound involving the periodontal tissues. These case studies show how soft tissue grafting may be used as a strategy to assist in the closure and enhancement of large wounds that present a chronic and complicated healing process.

Methods and results: Two healthy adult patients presented open wounds induced by trauma following the dental treatment. These wounds were treated with autogenous soft tissue grafting to enhance and stimulate the healing process. In one case, enamel matrix derivative was applied in conjunction with a gingival graft. Both cases demonstrated a successful and rapid wound closure at the 1-week post-treatment.

Conclusion: Using autogenous soft tissue grafting should be considered a treatment alternative when dealing with a chronic and problematic open wound. This study describes the success of two cases utilizing this approach. However, an understanding of the biological process of wound healing is critical when selecting a surgical technique for the treatment of a chronic wound.

Key points: There is limited information in the periodontal literature about the management of chronic wounds caused by trauma. Critical understanding of the biological process of wound healing and application of surgical principles are essential in using autogenous soft tissue grafts to treat these wounds. Surgical factors such as extent, location of wound, and limited amount of autogenous donor tissue are primary limitations to the successful treatment of these cases.

Plain language summary: Two cases that presented chronic wounds related to the periodontal tissues which were the result of surgical trauma are reported. These complicated healing wounds were managed with free autogenous soft tissue grafts. The grafts assisted the problematic wounds in healing by replacing missing tissue and providing growth factors. This mode of treatment for a chronic wound proved to be a successful approach in the management of this type of chronic wound.