In a recent webinar, a panel of clinicians highlighted their use of PriMatrix® around the adaptability of the technology. Their surgical indications include cases of large necrotizing fasciitis wounds, extremity trauma cases and large surface area burn wounds.
Below, they share their dressing protocols after applying PriMatrix.
Note that the opinions expressed, and techniques described, herein are based on the clinical experience of the physicians with this product and his or her professional judgment. The results presented are case-specific and should not be used to draw general conclusions as to clinical outcomes.
This Q&A is intended to educate physicians but represents only general guidance on the use of the product. Physicians are advised to rely on their own clinical experience and professional judgment in the use of the product on their patients. Note that the safety and effectiveness of concomitant use of PriMatrix with negative pressure wound therapy has not been established or cleared by the FDA.
“After we apply PriMatrix, what dressings do we use?
I’m going to make up a wound: a middle, third exposed tibia from a burn. The burn has been completely excised and you’ve got like a 3×5 area of exposed anterior facing the tibia.
Dr. Mittal, What’s your dressing regimen for that?”
– Dr. Peter Arnold
Professor and Chief of Plastic & Reconstructive Surgery
Chief of Staff, University of Mississippi Medical Center
“My go-to dressing regimen is Xeroform with a very, very thick layer of—we have gentamycin ointment readily available here—so we use that directly on the PriMatrix, and then a negative pressure dressing.
But if it’s a small area like that, I could also just as easily just wrap that followed with Kerlix and an Ace.”
– Dr. Rohit Mittal
Assistant Professor of Surgery, Emory University School of Medicine, Grady Memorial Hospital
“I actually just directly wound vac onto it.
I haven’t used any other layer in between except for some of these necrotizing soft tissue infections. Either I’ll use a silver back or I’ll use something like an UrgoTul or something that has a little bit of silver in it. But I usually just wound vac directly on top of it.”
– Dr. Nicole Kopari
Assistant Medical Director, Leon S. Peters Burn Center, UCSF Fresno Community Medical Center
“I use the Adaptic with a vac. After 5 to 7 days, then it’s hydro gel, Adaptic, Kerlix and an Ace.
The size of the wounds that you guys were showing are a little bit bigger than what I’m showing. I tend to not use the mesh. I’ll use fenestrated or whole sheets.
I think that it’s managed a little bit differently because your burden of making sure that it stays moisturized is significantly higher when you don’t have those interstices to allow it to stay hydrated.”
– Dr. Suhail Mithani
Associate Professor Plastic and Orthopaedic Surgery, Duke University Medical Center
“I’m similar. I’m Adaptic wound vac. I like the idea of the gentamycin ointment if it’s available, because I think that you get ahead of any potential problems and that’s like a burn move. I think that makes a whole lot of sense.”
– Dr. Peter Arnold
Professor and Chief of Plastic & Reconstructive Surgery
Chief of Staff, University of Mississippi Medical Center
**Dr. Arnold, Dr. Kopari and Dr. Mithani were paid consultants of Integra LifeSciences when this webinar occurred.
PriMatrix
Indications
PriMatrix is intended for the management of wounds that include:
- Partial and full thickness wounds
- Pressure, diabetic, and venous ulcers
- Second-degree burns
- Surgical wounds-donor sites/grafts, post-Moh’s surgery, post-laser surgery, podiatric, wound dehiscence
- Trauma wounds-abrasions, lacerations, and skin tears
- Tunneled/undermined wounds
- Draining wounds
Contraindications
PriMatrix® should not be used for patients with a known history of hypersensitivity to collagen or bovine products
Warnings and Precautions
PriMatrix® should be used with caution in regions where an infection exists or is suspected. Treat any existing infection appropriately.
PriMatrix should not be applied directly on third-degree burns.
PriMatrix Ag
Indications
PriMatrix Ag Antimicrobial is intended for the management of wounds that include:
- Partial and full thickness wounds
- Pressure, diabetic, and venous ulcers
- Second-degree burns
- Surgical wounds- donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence
- Trauma wounds- abrasions, lacerations, and skin tears
- Tunneled/ undermined wounds
- Draining wounds
Contraindications
PriMatrix® Ag should not be used for patients with a known history of hypersensitivity to collagen or bovine products
This device is not indicated for third-degree burns.
Warnings and Precautions
PriMatrix® Ag should be used with caution in regions where an infection exists or is suspected. Treat any existing infection appropriately.
Silver-containing compounds are known to cause a condition known as argyria, a silver-induced darkening of the skin. Frequent or prolonged use of PriMatrix Ag Antimicrobial may result in skin discoloration.