Surgeons share how they evaluate whether a wound bed is ready for either an acellular dermal matrix or a skin graft
Cytal® Wound Matrix and MicroMatrix® UBM Particulate provide a range of options for tailored wound management. They are manufactured using a proprietary MatriStem UBM™ (Urinary Bladder Matrix) technology, which has been shown to support the body’s ability to remodel site-appropriate tissue.1,2
The fully resorbable, porcine-derived UBM devices are designed to work independently or together to offer a wide range of treatment options for partial- and full-thickness wounds. Refer to the approved device labeling IFU (instructions for use) for the full list of wound indications.
Read below for five key steps for product preparation and application of these devices on full-thickness wounds.
- Wound Bed Preparation
Before using Cytal and MicroMatrix wound management devices, the wound must first be debrided of necrotic or non-viable tissue, and any infection must be managed. If active infection is present, treat the patient to resolve infection prior to device application.
- Device Preparation
MicroMatrix UBM Particulate
The product may be applied dry or may be mixed with saline to form a paste. A paste may be helpful for wounds that are difficult to access or where dry application would not be possible. To hydrate, dispense MicroMatrix into a sterile container and slowly add sterile saline until desired consistency is obtained.
Cytal Wound Matrix
Hydrate the device(s) with room temperature, sterile saline (0.9%) or lactated Ringer’s solution. Note that it will take Cytal Wound Matrix 1- or 2-Layer approximately 2 minutes to hydrate. Cytal Wound Matrix 3- or 6-Layer will hydrate in approximately 5 minutes.
Please note: Cytal Wound Matrix sheets may be cut to fit irregularly shaped wounds.
- Device Orientation
Cytal Wound Matrix
When the notched edge is in the upper right corner, the smooth basement membrane side of the device is facing up. Place the basement membrane side facing up and the lamina propria side towards the wound.
Note: Device orientation is not applicable for Cytal Wound Matrix 1-Layer sheets due to its faster resorption rate.
- Device Application
MicroMatrix UBM particulate
Apply the powder or paste directly to the wound bed, covering the entire wound with an even distribution of product. Always apply MicroMatrix UBM Particulate first if also using Cytal Wound Matrix .
Cytal Wound Matrix
Apply the device(s) directly to the wound. Cytal Wound Matrix may be secured by sutures, staples or steristrips, if necessary.
Note: For large wounds, more than one Cytal Wound Matrix sheet may be necessary to obtain complete coverage. Slightly overlap device edges to ensure complete wound coverage.
- Wound Dressing
Primary Dressing
Cover the device(s) with a non-adherent dressing. The dressing may be sutured or stapled in place to protect the device. If the wound is dry or in an area that is prone to dryness, apply a moisture-adding dressing such as hydrogel to sufficiently hydrate the wound. If the wound is heavily exudative, apply an absorptive dressing on top of the non-adherent dressing.
Secondary Dressing
Secure the primary dressing in place with a secondary dressing that will bolster and protect the wound.
- Valerio, Ian L et al. “The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care.” Regenerative medicine vol. 10,5 (2015): 611-22. Doi:10.2217/rme.15.34.
- Paige, John T et al. “Modulation of inflammation in wounds of diabetic patients treated with porcine urinary bladder matrix.” Regenerative medicine vol. 14,4 (2019): 269-277. doi:10.2217/rme-2019-0009.
MicroMatrix UBM Particulate
INDICATIONS
MicroMatrix UBM Particulate is intended for the management of wounds including: partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, second-degree burns, skin tears), and draining wounds. The device is intended for one-time use.
CONTRAINDICATIONS
- Patients with known sensitivity or allergy to porcine materials.
- Third-degree burns.
WARNINGS
- If active infection is present, treat patient to resolve infection prior to device application.
- Do not use glass vial if cracked, broken, or otherwise damaged.
- MicroMatrix UBM Particulate is not indicated for treatment of alopecia.
PRECAUTIONS
Do not tap glass vial with metal objects or handle in a way that may cause glass to break and contaminate wound.
Cytal
INDICATIONS
Cytal Wound Matrix is intended for the management of wounds including: partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, second-degree burns, skin tears), and draining wounds. The device is intended for one time use.
CONTRAINDICATIONS
- Patients with known sensitivity or allergy to porcine materials.
- Third-degree burns.
WARNINGS
- Exposure to contaminated or infected field can lead to rapid breakdown of device.
- If active infection is present, treat patient to resolve infection prior to device application.
- Do not use if cracked, broken, or otherwise damaged.
PRECAUTIONS
Always use aseptic technique when handling device.
Cytal Burn Matrix
INDICATIONS
Cytal Burn Matrix is intended for the management of wounds including: second-degree burns, partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/ grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, skin tears), and draining wounds. The device is intended for one time use.
CONTRAINDICATIONS
- Patients with known sensitivity or allergy to porcine materials.
- Third-degree burns.
PRECAUTIONS
Always use aseptic technique when handling device.