⚠️

Medical Content Warning

This page contains graphic clinical images related to surgical procedures. These images are intended for educational and professional purposes only and may be disturbing to some viewers. By proceeding, you confirm that you are 18 years of age or older and that you understand and accept the nature of the content.

No, take me back to the homepage

Clinical Proof

This is not wound care. This is a change in treatment strategy.

"The goal is not to close a wound. The goal is to return a patient to life." Dr. Moris Topaz, MD, PhD, Founder & CEO. Seven representative cases across the toughest wound categories, treated with TopClosure®, ROI-NPT and CITA.

Before / During / After Results ↓ In-Depth Case Studies

1000+

Cases treated worldwide

28yr

Clinical experience

35+

Peer-reviewed publications

Complex wound categories

Real Patient Results

Before. During. After.

Thirteen real cases across every clinical application. The middle stage shows the wound managed with IVT Medical technology: TopClosure®, Vcare α® or MeCare α®.

Drag the handles on each image to move between the three stages

Before treatment: Large sarcoma resection, healed at 3 months

Before TopClosure® After

Large sarcoma resection, healed at 3 months

Large Skin Defects

Before treatment: Wide excision of malignant melanoma (back)

Before TopClosure® After

Wide excision of malignant melanoma (back)

Major Tumor Resection

Before treatment: Giant defect, squamous cell carcinoma (flank)

Before TopClosure® After

Giant defect, squamous cell carcinoma (flank)

Major Tumor Resection

Before treatment: Large scalp defect, pediatric patient

Before TopClosure® After

Large scalp defect, pediatric patient

Pediatric Patients

Before treatment: Giant shoulder defect, closed within 2 hours

Before TopClosure® After

Giant shoulder defect, closed within 2 hours

Major Wound Defects

Before treatment: Infected pacemaker, closure at 3 weeks

Before MeCare α® NPT After

Infected pacemaker, closure at 3 weeks

Infected Pacemaker

Before treatment: Deep sternal wound infection, closed and healed

Before Vcare α® NPT After

Deep sternal wound infection, closed and healed

Deep Sternal Wounds

Before treatment: Hand trauma reconstruction

Before TopClosure® After

Hand trauma reconstruction

Hand Surgeries

Before TopClosure® After

Severe leg wound

Vascular Surgery

Before treatment: Diabetic foot ulcer, healed

Before NPT After

Diabetic foot ulcer, healed

Diabetic Foot

Before treatment: Crush-degloving forearm injury

Before TopClosure® After

Crush-degloving forearm injury

Orthopedic & Trauma

Before treatment: Bone infection, limb salvage at 2.5 months

Before TopClosure® After

Bone infection, limb salvage at 2.5 months

Orthopedic & Trauma

Before treatment: Combat leg injury, healed at 8 weeks

Before TopClosure® After

Combat leg injury, healed at 8 weeks

Combat Injuries

CASE 01 · TOPCLOSURE®

Large Skin Defect: Primary Closure Without Skin Grafts

Extremely large skin defect after tumor excision, closed primarily without grafts or flaps.

⚠ Clinical Challenge

Extremely large skin defect after tumor excision
Conventional approach: skin graft or flap reconstruction

⚕ IVT Approach

Immediate intraoperative stress-relaxation using TopClosure®
Progressive approximation without grafts or flaps

✓ Clinical Outcome

Complete primary closure within hours
Excellent long-term scar quality
No donor site morbidity

Giant tumor before excision — Baseline
Pre-operative

Large skin defect after tumor excision — Baseline
Post-excision defect

Primary closure using TopClosure, intraoperative — Treatment
Primary closure using TopClosure® (intraoperative)

CASE 02 · CITA + ROI-NPT + TOPCLOSURE®

Infected Wounds & Implant Salvage

Changing the strategy from removal to salvage.

⚠ Clinical Challenge

Deep and resistant wound infections
Infected implants (sternal wires, pacemakers, orthopedic hardware)
Conventional approach: implant removal + major reconstruction

⚕ IVT Approach

Local infection control using CITA
Controlled wound environment with ROI-NPT
Tissue preservation and stabilization with TopClosure®

✓ Clinical Outcome

Effective infection control
Implant preservation
Avoidance of major reconstructive surgery

Baseline
Infected wound with exposed implant

Treatment
During treatment: CITA targeted antibiotic delivery

ROI-NPT dressing over device pocket — Treatment
ROI-NPT wound dressing

MeCare regulated ROI-NPT device during therapy — Treatment
Regulated ROI-NPT therapy (MeCare α®)

TopClosure stabilization — Treatment
TopClosure® stabilization

Healed wound, implant preserved — Outcome
Healed wound, implant successfully preserved

CASE 03 · CITA-MIS + ROI-NPT + TOPCLOSURE®

Deep Sternal Wound Infection (DSWI)

Infection control without hardware removal, preserving chest wall integrity.

⚠ Clinical Challenge

DSWI traditionally associated with hardware removal and complex reconstruction
High risk of prolonged hospitalization and repeated interventions
Significant burden on patients and healthcare systems

⚕ IVT Approach

CITA-MIS for targeted local infection control
ROI-NPT for regulated wound environment optimization
TopClosure® for gradual tension-relief closure

✓ Clinical Outcome

Infection control without hardware removal
Preservation of chest wall integrity
Accelerated wound closure and recovery
Successful implant salvage

Deep sternal wound infection at presentation — Baseline
Deep sternal wound infection

Debridement with exposed sternum — Baseline
Debridement: exposed sternum

CITA and TopClosure during treatment — Treatment
During treatment: CITA + TopClosure®

ROI-NPT dressing on the chest — Treatment
ROI-NPT regulated wound environment

Treatment
Progressive tension-relief closure

Healed chest wall — Outcome
Healed wound, hardware preserved

Healed sternal wound close-up — Outcome
Long-term result, close-up

CASE 04 · CITA + ROI-NPT + TOPCLOSURE®

Diabetic Foot & Vascular Wounds

Preserving limbs, not just closing wounds.

⚠ Clinical Challenge

Chronic infected diabetic foot wounds
Compromised perfusion and poor tissue quality
High risk of major or repeated amputations
Conventional approach: staged debridement + prolonged NPWT ± amputation

⚕ IVT Approach

Local infection control using CITA
Controlled wound environment with ROI-NPT
Tissue stabilization and progressive closure with TopClosure®
Integration of closure, infection control, and pressure regulation

✓ Clinical Outcome

Effective infection control at the source
Accelerated wound healing
Avoidance or downgrading of amputations
Preservation of limb function and patient mobility

Infected diabetic foot at baseline — Baseline
Infected diabetic foot

TopClosure stabilization of the foot — Treatment
TopClosure® stabilization

ROI-NPT dressing on the foot — Treatment
During treatment: CITA + ROI-NPT

Progressive closure with TopClosure and CITA — Treatment
Progressive closure

Healed foot, limb preserved — Outcome
Healed wound, limb preserved

CASE 05 · TOPCLOSURE® + ROI-NPT (VCARE α®) + CITA

Open Abdomen & Complex Abdominal Closure

Restoring abdominal integrity while avoiding grafts and prosthetic reconstruction.

⚠ Clinical Challenge

Open abdomen following trauma, infection, transplantation, or compartment syndrome
Massive soft tissue defects with loss of abdominal domain
High risk of visceral exposure, infection, and fluid loss
Conventional management: mesh implantation, skin grafting, or prolonged open abdomen therapy

⚕ IVT Approach

Early tissue stabilization using TopClosure®
Controlled tension-relief approximation of abdominal wall tissues
Optimized wound environment using ROI-NPT (Vcare α®)
Infection management when indicated using CITA
Progressive delayed primary closure preserving native tissue

✓ Clinical Outcome

Successful abdominal wall closure without complex flap reconstruction
Reduced need for permanent prosthetic materials
Preservation of viable tissue and abdominal function
Reduced hospitalization and accelerated recovery

Open abdomen with massive soft tissue defect — Baseline
Open abdomen, massive soft tissue defect

Treatment
Early stabilization with TopClosure®

ROI-NPT dressing on the abdomen — Treatment
Optimized wound environment: ROI-NPT (Vcare α®)

Treatment
Progressive tension-relief approximation

CASE 06 · TOPCLOSURE® + RNPT (VCARE α®)

Trauma & Limb Salvage

Crush–degloving injury with preservation of joint and prosthetic function.

⚠ Clinical Challenge

Severe crush–degloving injury following motor vehicle accident
Near-complete traumatic below-knee amputation
Extensive soft tissue destruction and major skin defect
High risk of conversion to above-knee amputation, loss of prosthetic potential

⚕ IVT Approach

Immediate stabilization and tension control using TopClosure®
Preservation of viable tissue and joint anatomy
Progressive soft tissue reconstruction without skin grafts or flaps
Focus on functional limb salvage, not only wound closure

✓ Clinical Outcome

Successful preservation of the knee joint, above-knee amputation avoided
Stable soft tissue coverage of the stump
Prosthetic fitting and active rehabilitation enabled
Restoration of patient mobility and independence

Initial crush degloving injury — Baseline
Initial crush–degloving injury

Baseline
Extensive soft tissue destruction

Immediate wound stabilization with TopClosure — Treatment
Immediate wound stabilization

Regulated NPWT with Vcare in the operating room — Treatment
Controlled wound environment: regulated NPWT (Vcare α®)

Patient ambulating with prosthesis — Outcome
Joint preserved, patient ambulating with prosthesis

CASE 07 · TOPCLOSURE® + ROI-NPT + CITA

Pressure Ulcers & Functional Reconstruction

Restoring tissue integrity while preserving rehabilitation potential.

⚠ Clinical Challenge

Large chronic pressure ulcers in immobilized, high-risk patients
Deep tissue destruction with recurrent contamination and infection
Exposure of bone, tendon, or underlying structures
Conventional approach: prolonged wound care or complex flap reconstruction

⚕ IVT Approach

Early wound stabilization and tension control using TopClosure®
Controlled wound environment with ROI-NPT
Local infection management using CITA
Progressive tissue approximation while preserving viable tissue

✓ Clinical Outcome

Accelerated wound closure and tissue recovery
Effective infection control at the source
Reduced reconstructive burden and surgical complexity
Earlier rehabilitation, preservation of independence and quality of life

Advanced pressure ulcer at baseline — Baseline
Advanced pressure ulcer

Baseline
Deep tissue destruction after debridement

TopClosure and CITA application — Treatment
TopClosure® + CITA application

ROI-NPT controlled wound environment — Treatment
Controlled wound environment: ROI-NPT

Treatment
Progressive wound closure and tissue recovery

Healed wound after reconstruction — Outcome
Healed wound, successful reconstruction

Outcome
Patient rehabilitation and restored mobility

Clinical images are presented for educational and professional purposes. Individual results may vary; treatment decisions rest with the attending physician.

Explore the science behind the cases

Peer-reviewed publications documenting these approaches in JACC, Annals of Surgery, BMJ Case Reports and more.

Research & Publications →