HEMIGARD^® ARS Clinical Cases

The HEMIGARD® ARS Device allowed a high tension retention suture to close a facial wound under high tension in a patient on anticoagulants. Once closed with the HEMIGARD® ARS, the wound needed only delicate dermal sutures and GluSeal® acrylate glue. We avoided procedures like wide undermining and local flaps that increase postoperative risks.

Two HEMIGARD® ARS devices and and 2-0 nylon retention sutures used to close this very tight ankle surgical wound. HEMIGARD® ARS can support the wound through early healing to prevent wound dehiscence, which can occur in up to 10% of leg wounds.

HEMIGARD® ARS device and 3-0 nylon retention suture used to close surgical arm wound under tension in very fragile skin without ripping.

HEMIGARD® ARS strips and 0 nylon retention suture to close this surgical wound under high tension and avoid a large facial flap or graft.

HEMIGARD® ARS device and 0 nylon retention suture used to close this lower leg wound under high tension in very fragile skin and support it postoperatively to prevent dehiscence.

HEMIGARD® ARS device and 2-0 nylon retention suture was used to bolster the skin and close this dorsal hand surgical wound. A wound like this usually requires a skin graft, which was avoided here.

HEMIGARD® ARS device and 3-0 nylon retention suture used to close this arm wound under tension in fragile skin and support it post-operatively.

HEMIGARD® ARS device and Quill® barbed suture used in combination to relieve tension.

56 year old female patient with uncontrolled diabetes required a transmetatarsal amputation for gas gangrene of the right foot. Subsequent Lisfranc level amputation and wound closure with nine HEMIGARD® ARS devices and nylon suture. Use of the HEMIGARD® ARS devices meant less need for dermal sutures, which reduced foreign body nidus for infection and saved at least 6 minutes of OR time saved. Wound was healing well at the time of HEMIGARD® ARS removal (Day 22).

60 year old male with diabetes and bilateral Charcot foot deformities. Similar procedures had been done on both feet to correct deformities. In the right foot (not shown), the patient suffered postoperative complications requiring eventual return to the OR for removal of hardware. In his left foot (shown here), HEMIGARD® ARS was used to offload tension and reduce skin tearing. Intraoperatively, 20 minutes of OR time was saved by requiring less dermal sutures and having less skin tearing intraoperatively. While sutures are typically removed at week 4 postop, the wound had healed sufficiently by Day 23 to remove ALL sutures and HEMIGARD® devices.

88 year old female on Eliquis® sustained a deep left pretibial laceration with very fragile surrounding skin. After flushing and debridement, the delicate skin would not allow routine wound closure. Two pairs of HEMIGARD® ARS were used to bolster the skin and permit closure. Steristrips were used to support the wound edges. The wound had healed well at 4 weeks.

93 year old female on Eliquis® had friable, bleeding infiltrative basal cell carcinoma of the right shin (tumor outlined with sterile purple marking). The 4cm wide x 6cm long defect could not be approximated and was surrounded by fragile skin. Due to her Eliqus®, second intent healing was inappropriate, and we wished to avoid a skin graft. A single HEMIGARD® ARS device was used with 0 nylon suture to approximate the wound. Two 4-0 polyglactin interrupted dermal sutures and a 4-0 nylon running horizontal mattress suture used to finish closure.