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Case Reports in Medicine
Volume 2013 (2013), Article ID 716549, 3 pages
Case Report

Nonsurgical Treatment of a Massive Substance Loss

Department of Plastic, Reconstructive and Aesthetic Surgery, University of Rome “Sapienza”, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy

Received 7 April 2013; Accepted 1 August 2013

Academic Editor: John Kortbeek

Copyright © 2013 Pasquale Fino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Traumatic wounds are caused by severe trauma, resulting in lesions with extensive skin and subcutaneous tissue loss and damage to tissue viability. A “difficult wound” is a solution of continuity that does not heal spontaneously within three months. The factors that determine it may be as follows: a massive loss of substance, an infection, the presence of foreign bodies, or the clinical condition of the patient. We report a case of a 25-year-old man that presents a skin lesion on the anterior region of the left arm with extensive necrosis of skin and subcutaneous plants that involve the underlying muscle planes, caused by a trauma due to a car accident. In most of the lesions of such size and position, there is always a need for surgery. But in this case, considering the young age and the regenerative capacity of the patient, a quick and targeted antibiotic therapy was chosen, combined with debridement and worked with collagenase ointment.