Watch Urinary Bladder Matrix Technology in Action

As a college undergraduate, Alan Spievack cut limbs off of salamanders in order to research how long it took them to regenerate. Fifty years later, Spievack, then an MD, used a powdered extract of pig bladder to repair his brother’s finger when a model airplane propeller sliced off the tip.

Spievack’s research on cell regeneration and extracellular matrices (ECM) ultimately led to the development of MatriStem Urinary Bladder Matrix (UBM)™ technology, designed for the management of complex wounds and reinforcement of hernia repairs.

MatriStem UBM is an ECM scaffold derived from porcine (pig) urinary bladder. It is used in:

• • Cytal® Wound and Cytal Burn Matrix (sheets), and MicroMatrix® (particulate) devices to manage acute¹ and chronic wounds²
  • Gentrix® Surgical Matrix, which is intended for the reinforcement of soft tissue where weakness exists, which may include a variety of hernia¹ repairs including:
  • Ventral hernias
  • Hiatal hernias
  • Parastomal hernias

Characteristics of UBM

To create UBM, porcine bladders are harvested and minimally processed via a proprietary manufacturing process that preserves the integrity of essential structures and molecular components so that only two distinct layers remain:

• • An intact epithelial basement membrane: A thin, dense collagen structure that may contribute to cell attachment
  • A lamina propria: Open and porous surface that allows for cellular infiltration and capillary ingrowth

This process results in UBM devices that are naturally derived, three-dimensional scaffolds, which contain a collection of collagens and other proteins including laminin and proteoglycans³ and numerous growth factors⁴—all important in tissue healing. The resulting products are also non-crosslinked, completely resorbable and decellularized.

Cellular Responses to UBM

After a MatriStem UBM device is placed in the body, white blood cells including macrophages and neutrophils will enter the UBM scaffold to initiate the remodeling response. Fibroblasts will also enter the scaffold, depositing various collagens that provide strength and structure for the new tissue, and new blood vessels will form transporting blood and nutrients to the site of repair.^5-8

UBM provides an environment where the body is more likely to exhibit a higher ratio of M2 to M1 macrophages^5,9, which has been shown to facilitate the remodeling of site-appropriate tissue.⁵ UBM supports the development of healthy tissue that mimics the structure and biomechanical functionality of the surrounding anatomy. Over time, the devices will fully resorb and completely remodel into the host tissue, leaving no foreign body.^5-8

Watch the animation above to see UBM in action.

References

1. Valerio IL, Campbell P, Sabino J, Dearth CL, Fleming M. The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care. Regen Med. 2015;10(5):611-22.
2. Alvarez OM, Smith T, Gilbert TW, Onumah NJ, Wendelken ME, Parker R, Markowitz L. Diabetic Foot Ulcers Treated With Porcine Urinary Bladder Extracellular Matrix and Total Contact Cast: Interim Analysis of a Randomized, Controlled Trial. Wounds. 2017 May;29(5):140-146. Epub 2017 Feb 27. PMID: 28267677.
3. Brown B, Lindberg K, Reing J, Stolz DB, Badylak SF. The basement membrane component of biologic scaffolds derived from extracellular matrix. Tissue Engineering. 2006; 12:519-526.3.
4. Growth factor data on file; MEMO-1108.
5. Brown BN, Londono R, Tottey S, Zhang L, Kukla KA, Wolf MT, Daly KA, Reing JE, Badylak SF†. Macrophage phenotype as a predictor of constructive remodeling following the implantation of biologically derived surgical mesh materials. Acta Biomaterialia. 2012; 8:978-987.
6. Sasse KC, Lambin JH, Gevorkian J, et al. Long-term clinical, radiological, and histological follow-up after complex ventral incisional hernia repair using urinary bladder matrix graft reinforcement: a retrospective cohort study. Hernia. 2018;22(6):899-907.
7. Riganti JM, Ciotola F, Amenabar A, Craiem D, Graf S, Badaloni A, Gilbert TW*, Nieponice A‡. Urinary bladder matrix scaffolds strengthen esophageal hiatus repair. Journal of Surgical Research. 2016; 204:344-50.
8. Young DA, Jackson N, Ronaghan CA, Brathwaite CEM, Gilbert TW. Retrorectus repair of incisional ventral hernia with urinary bladder matrix reinforcement in a long-term porcine model. Regenerative Medicine. 2018; doi:10.2217/rme-2018-0023.
9. Paige JT, et al. Modulation of inflammation in wounds of diabetic patients treated with porcine urinary bladder matrix. Regenerative Medicine. 2019 May;14(4):269-277. doi:10.2217/rme-2019-0009. Epub 2019 Apr 25.

MICROMATRIX INDICATIONS

MicroMatrix 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.

MICROMATRIX CONTRAINDICATIONS

1. Patients with known sensitivity or allergy to porcine materials.
2. Third-degree burns.

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.

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.

CYTAL CONTRAINDICATIONS

1. Patients with known sensitivity or allergy to porcine materials.
2. Third-degree burns.

GENTRIX INDICATIONS

GENTRIX THIN INDICATIONS

Gentrix Surgical Matrix Thin is intended for implantation to reinforce soft tissue where weakness exists in patients requiring urological, gastroenterological, or plastic & reconstructive surgery. Reinforcement of soft tissue within urological, gastroenterological, and plastic & reconstructive surgery includes, but is not limited to, the following open or laparoscopic procedures: hernia and body wall repair, colon and rectal prolapse repair, tissue repair, and esophageal repair. Gentrix Surgical Matrix Thin minimizes tissue attachment to the device in case of direct contact with viscera.

GENTRIX THIN CONTRAINDICATIONS

Patients with known sensitivity or allergy to porcine materials.

GENTRIX SURGICAL MATRIX INDICATIONS

Gentrix Surgical Matrix is intended for implantation to reinforce soft tissue where weakness exists in patients requiring gastroenterological or plastic & reconstructive surgery. Reinforcement of soft tissue within gastroenterological and plastic & reconstructive surgery includes, but is not limited to, the following open or laparoscopic procedures: hernia (e.g. hiatal/diaphragmatic) and body wall repair, colon and rectal prolapse repair, tissue repair, and esophageal repair.

Gentrix Surgical Matrix minimizes tissue attachment to the device in case of direct contact with viscera.

GENTRIX CONTRAINDICATIONS

Patients with known sensitivity or allergy to porcine materials.

GENTRIX HIATAL INDICATIONS

Gentrix Surgical Matrix Hiatal is intended for implantation to reinforce soft tissue where weakness exists in patients requiring gastroenterological or plastic & reconstructive surgery. Reinforcement of soft tissue within gastroenterological and plastic & reconstructive surgery includes, but is not limited to, the following open or laparoscopic procedures: hernia (e.g.: hiatal/diaphragmatic) and body wall repair, colon and rectal prolapse repair, tissue repair, and esophageal repair. Gentrix Surgical Matrix Hiatal minimizes tissue attachment to the device in case of direct contact with viscera.

GENTRIX HIATAL CONTRAINDICATIONS

Patients with known sensitivity or allergy to porcine materials.

GENTRIX PLUS INDICATIONS

Gentrix Surgical Matrix Plus is intended for implantation to reinforce soft tissue where weakness exists in patients requiring gastroenterological or plastic & reconstructive surgery. Reinforcement of soft tissue within gastroenterological and plastic & reconstructive surgery includes, but is not limited to, the following open or laparoscopic procedures: hernia (e.g. hiatal/diaphragmatic) and body wall repair, colon and rectal prolapse repair, tissue repair, and esophageal repair.

Gentrix Surgical Matrix Plus minimizes tissue attachment to the device in case of direct contact with viscera.

GENTRIX PLUS CONTRAINDICATIONS

Patients with known sensitivity or allergy to porcine materials.

GENTRIX THICK INDICATIONS

Gentrix Surgical Matrix Thick is intended for implantation to reinforce soft tissue where weakness exists in patients requiring gastroenterological or plastic & reconstructive surgery. Reinforcement of soft tissue within gastroenterological and plastic & reconstructive surgery includes, but is not limited to, the following procedures: hernia and body wall repair, colon and rectal prolapse repair, tissue repair, and esophageal repair.

GENTRIX THICK CONTRAINDICATIONS

Patients with known sensitivity or allergy to porcine materials

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