A 25-year-old male with colitis ulcerosa treated with prednisone was transferred to our department with a soft tissue defect at the left neck and upper left thorax after local necrosis following an abscess due to an erroneous puncture of a central line (Figure 2a ). After several debridements, applying vacuum- and antibiotic therapy combined with continuing a low dose prednisone therapy, the wound was vital and microbiologically free of bacteria. As reconstructive surgery, we decided to perform a supraclavicular artery island flap. The postoperative wound healing process showed no signs of infection with only a minor dehiscence at the drainage area so that we could discharge the patient with a good reconstructive result (Figure 2b ).\nHowever, following the necessity of increasing the prednisone therapy due to an acute period of colitis ulcerosa, the patient presented himself again 3 weeks after being discharged with multiple dehiscence around the elevation site of the supraclavicular flap with serous outflow. The microbiological tests showed no evidence of bacteria. After multiple debridements, the secondary wound was covered with skin grafts using MatriDerm® as dermal matrix (Figure 2c, d ). The young, immunocompromised patient could finally be discharged after an overall hospitalization stay of more than 12 weeks.
A 72-year-old woman with the initial diagnosis of a malignant melanoma on the right lower leg presented to our clinic after an in sano excision in a clinic alio loco. However, after further excision of the melanoma, we closed the wound using skin mesh-graft. After complete wound healing, the patient received a low-dose interferon therapy with Roferon. After 3 months, the patients presented to us with worsening of the wound condition and a reappearance of activated melanoma in situ of the scar on the right lower leg. Therefore, a radical excision of the pretibial scar and a temporary covering with alloplastic material was performed. After several debridements, a clean granulating wound could be achieved making it possible to cover the defect of the lower leg with a free radial forearm flap from the right forearm. Finally, the patient could be discharged with normal wound healing from our department and received further chemotherapy without any sign of re-appearance of the malignant melanoma so far.