Closed Great Toe Amputation Treated with Bovine Dermal Collagen Matrix as Wound Healing Adjunct

Introduction: Great toe amputation is frequently performed to address infected foot ulcers. Due to underlying comorbidities and condition of the distal foot, healing can be compromised, even after removal of non- viable tissue. We present a case of closed great toe amputation utilizing a fibrillar particulate collagen matrix as a wound healing adjunct. Bovine dermal collagen matrix* is an absorbent extracellular matrix (ECM) com- prised of Type I and Type III bovine collagen that closely resembles the human body’s native collagen and is designed to support the wound heal- ing process. Fibrillar collagen derived from bovine dermis is biocompati- ble, biodegradable, and is used in this case as a wound healing adjunct. Methods: 88-year-old female with type 2 diabetes, CKD3, admitted with infected left great toe wound and osteomyelitis. Results: Great toe amputation with primary closure was performed in an 88-year-old comorbid female to remove infected ischemic toe. Bovine dermal collagen matrix* was utilized under the surgical closure to provide a collagen scaffold to aid and maintain wound healing. Surgical wound closure and strength were maintained without complications upon follow up at days 27, 49 and 83. Discussion: Bovine dermal collagen matrix* provides a collagen scaf- fold like human native collagen and is known to sequester excess prote- ases away from the wound bed, allowing blood and new vessel formation to integrate within its scaffold. Bovine dermal collagen matrix* contains intrinsic hemostatic properties to control minor bleeding and is 100% resorbable through normal metabolic pathways. Distal toe amputations present a challenge to wound healing and risk dehiscence, infection and ischemic complications. This case shows successful primary intent clo- sure with bovine dermal collagen matrix*, maintaining a closed incision without wound complications. *HELIOGEN, Mimedx, Inc