Clinical Application of Intrasite™ Hydrogel Dressing for the Management of Facial Gunshot Wounds With a Complex Soft Tissue Avulsion Defect

Abstract

Study Design Case report Objective To present an alternative method to traditional iodoform gauze packing for the management of soft tissue defects. Hydrogel dressings are modern packing materials that can be used to hold negative space, provide moisture to the wound, and absorb wound exudates. Methods This report describes the case of a 28-year-old patient who suffered facial gunshot injuries, including an approximately 3-centimeter diameter avulsion of soft tissue at the posterior right cheek. After wound debridement and irrigation, Intrasite™ hydrogel was used as a wound dressing to fill the soft tissue defect. The injectable and slowly resorbable material was added as needed by the patient for eight weeks until wound healing. Results Wound healing by secondary intention was achieved with acceptable esthetic outcomes while avoiding traditional dressing changes. Conclusions Facial gunshot wounds present a multitude of challenges particularly when complex soft tissue avulsions are involved. The surgeon must adequately debride these wounds and manage soft tissue healing to prevent infection and ensure satisfactory aesthetic and functional outcomes. Long-term patient compliance is equally important; however, dressing changes are often difficult and uncomfortable for the patient. The use of an injectable hydrogel dressing facilitated soft tissue healing while affording greater comfort to the patient compared with traditional dressing changes, thus likely improving compliance during the crucial healing period.