Surgeons share how they evaluate whether a wound bed is ready for either an acellular dermal matrix or a skin graft
PriMatrix® is a unique dermal repair scaffold for the management of the most challenging wounds. PriMatrix is offered in solid, fenestrated, and meshed configurations, in a range of sizes available for trauma, and other challenging partial and full-thickness wounds.
PriMatrix is indicated for the management of wounds that include partial and full thickness wound; pressure, diabetic, and venous ulcers; second-degree burns; surgical wounds – donor site/grafts; post-mohs surgery, post-laser surgery; podiatric, wound dehiscence; trauma wounds – abrasions; lacerations and skin tears; tunneled/undermined wounds and draining wounds.
PriMatrix should not be used for patients with a known history of hypersensitivity to collagen or bovine products.
Read below for seven key steps for applying PriMatrix on full-thickness wounds:
Step 1: Prepare Viable Wound Bed
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- Remove all eschar, necrotic, and infected tissue.
- The tissue bed and margins should contain skin edges with bleeding dermis, subcutaneous fat with punctuate bleeding, scored fascia, and red/pink muscle.
Step 2: Prepare PriMatrix
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- Trim PriMatrix to cover the prepared wound bed with minimal overlap.
- Hydrate PriMatrix in room temperature sterile saline.
Step 3: Apply and Secure PriMatrix
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- Expand and smooth PriMatrix across the wound to ensure intimate contact with the wound bed.
- Staple or suture PriMatrix to wound edge with minimal overlap.
- Staple or suture adjacent pieces of PriMatrix.
Step 4: Moist Wound Therapy: Apply Standard Dressings to PriMatrix
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- Apply a non-adherent contact layer directly over PriMatrix.
- Use appropriate products and secondary dressings to maintain moist wound healing.
- Use dressings to bolster PriMatrix to ensure contact between PriMatrix and the wound bed.
Step 5: Moist Wound Therapy: Perform Standard Wound Care
Day 1-2:
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- Remove dressings down to petrolatum gauze, replace ointment, absorbent dressings, and elastic bandage wrap.
- Range of motion can begin.
Day 3-5:
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- Remove all dressings down to non-adherent contact layer (remove non-adherent contact layer when PriMatrix has attached to the wound bed).
- Replace dressings.
Day 5+:
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- Remove all dressings, staples and sutures.
- Gently wash wound, and replace all dressings.
Step 6: Assess Tissue Generation Post-PriMatrix Application
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- Assess epithelialization progress.
- PriMatrix managed wounds will re- epithelialize from the wound margins.
Step 7: Apply Split-Thickness Skin Graft
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- For larger wounds, a split-thickness skin graft may facilitate final wound closure.
- Prepare generated tissue for skin graft application using a gentle abrasion system.
- Harvest a 0.008 to 0.012 inch-thick skin graft.
For successful application, note the following warnings and precautions when using PriMatrix:
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- Do not expose to chemicals or substances other than sterile, room temperature 0.9% saline.
- Excessive heat can damage collagen. Do not hydrate in 0.9% saline warmed above room temperature. If, when hydrated, the product shrinks in size, DO NOT use the product as it may be damaged.
- PriMatrix should be used with caution in regions where an infection exists or is suspected. Treat any existing infection appropriately.
- Do not resterilize as this may damage PriMatrix.
- Do not use if the product package is damaged or opened.
- PriMatrix is for single patient use only.
- Rinse surgical gloves to remove glove powder prior to touching PriMatrix.
- Do not use product if past the date of expiration indicated on the product label.
- Meshing of fenestrated PriMatrix is not recommended.
- PriMatrix should not be applied directly on third degree burns.