Effective Management of Major Lower Extremity Wounds Using an Acellular Regenerative Tissue Matrix: A Pilot Study

Brigido, Stephen A.; Boc, Steven F.; López, Ramon

doi:10.3928/0147-7447-20040102-14

Cited by 83 publications

(39 citation statements)

References 9 publications

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“…Brigido et al (34) in a prospective, randomised study reported faster healing of chronic, full-thickness, lower extremity wounds at a significantly faster rate compared with conventional treatment when using an acellular matrix dressing.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of allogenic acellular matrix therapy in treatment of diabetic foot wounds: an initial experience

Martin

Sangalang

et al. 2005

International Wound Journal

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The purpose of this study was to evaluate outcomes of persons with UT grade 2A neuropathic diabetic foot wounds treated with an acellular matrix. Data were abstracted for 17 consecutive patients with diabetes--76.5% males, aged 61.5 +/- 8.5 years with a mean glycated haemoglobin of 9.2 +/- 2.2% presenting for care at a large, multidisciplinary wound care centre. All patients received surgical debridement for their diabetic foot wounds and were placed on therapy consisting of a single application of an acellular matrix graft (GraftJacket; Wright Medical Technologies, Arlington, TN, USA) with dressing changes taking place weekly. Outcomes evaluated included time to complete wound closure and proportion of patients achieving wound closure in 20 weeks. Acellular matrix therapy was used as initial therapy and was sutured or stapled in place under a silicone-based non adherent dressing. Therapy was then followed by a moisture-retentive dressing until complete epithelialisation. In total, 82.4% of wounds measuring a mean 4.6 +/- 3.2 cm(2) healed in the 20-week evaluation period. For those that healed in this period, healing took place in a mean 8.9 +/- 2.7 weeks. We conclude that a regimen consisting of moist wound healing using an acellular matrix dressing may be a useful adjunct to appropriate diabetic foot ulcer care for deep, non-infected, non-ischaemic wounds. We await the completion of further trials in this area to confirm or refute this initial assessment.

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Section: Discussionmentioning

confidence: 99%

Outcomes of allogenic acellular matrix therapy in treatment of diabetic foot wounds: an initial experience

Martin

Sangalang

et al. 2005

International Wound Journal

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“…Biomaterials have been manufactured from both synthetic and biologic substrates and each has their associated advantages and disadvantages. 7 Of relevance to the present study, biologic scaffolds composed of mammalian extracellular matrix (ECM) are associated with a constructive remodeling outcome following injury, as opposed to fibrosis or the classic foreign body reaction, and have been used in many clinical applications including dermal, [8][9][10] cardiac, 11 musculoskeletal, [12][13][14][15] and gastrointestinal repair. 16 The host macrophage Additional Supporting Information may be found in the online version of this article.…”

Section: Introductionmentioning

confidence: 99%

Solubilized extracellular matrix bioscaffolds derived from diverse source tissues differentially influence macrophage phenotype

Dziki

Wang

Pineda

et al. 2016

J Biomedical Materials Res

147

107

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The host response to biomaterials is a critical determinant of their success or failure in tissue-repair applications. Macrophages are among the first responders in the host response to biomaterials and have been shown to be predictors of downstream tissue remodeling events. Biomaterials composed of mammalian extracellular matrix (ECM) in particular have been shown to promote distinctive and constructive remodeling outcomes when compared to their synthetic counterparts, a property that has been largely attributed to their ability to modulate the host macrophage response. ECM bioscaffolds are prepared by decellularizing source tissues such as dermis and small intestinal submucosa. The differential ability of such scaffolds to influence macrophage behavior has not been determined. The present study determines the effects of ECM bioscaffolds derived from eight different source tissues upon macrophage surface marker expression, protein content, phagocytic capability, metabolism, and antimicrobial activity. The results show that macrophages exposed to small intestinal submucosa (SIS), urinary bladder matrix (UBM), brain ECM (bECM), esophageal ECM (eECM), and colonic ECM (coECM) express a predominant M2-like macrophage phenotype, which is pro-remodeling and anti-inflammatory (iNOS-/Fizz1+/CD206+). In contrast, macrophage exposure to dermal ECM resulted in a predominant M1-like, pro-inflammatory phenotype (iNOS+/Fizz1-/CD206-), whereas liver ECM (LECM) and skeletal muscle ECM (mECM) did not significantly change the expression of these markers. All solubilized ECM bioscaffold treatments resulted in an increased macrophage antimicrobial activity, but no differences were evident in macrophage phagocytic capabilities, and macrophage metabolism was decreased following exposure to UBM, bECM, mECM, coECM, and dECM. The present work could have important implications when considering the macrophage response following ECM implantation for site-appropriate tissue remodeling. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 138-147, 2017.

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“…A 12‐week study using another tissue matrix, Graftskin (Apligraf; Organogenesis, Canton, MA, USA and Novartis Pharmaceuticals, East Hanover, NJ, USA), demonstrated that 56% of Graftskin‐treated patients healed compared with 38% for the control group (6). In all these studies, the foot ulcers were limited to Wagner grade‐1 foot ulcers (7). Over 50% of the patients treated with Graftskin required five applications of the tissue matrix (10–12).…”

Section: Introductionmentioning

confidence: 99%

The use of an acellular dermal regenerative tissue matrix in the treatment of lower extremity wounds: a prospective 16‐week pilot study

Brigido¹

2006

International Wound Journal

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120

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A prospective, single-centre, randomized controlled study was performed to evaluate the effectiveness of Graftjacket, a human acellular regenerative tissue matrix as a treatment option for chronic non healing lower extremity wounds. Twenty-eight diabetic patients with full-thickness wounds that had been present for at least 6 weeks were treated with sharp debridement and randomized to a single application of Graftjacket tissue matrix plus mineral oil-soaked fluff compression dressing or to a control treatment of wound gel with gauze dressings. All patients were seen weekly. By week 16, 12 of 14 patients treated with Graftjacket tissue matrix demonstrated complete wound closure compared with 4 of 14 patients in the control group. Patients treated with Graftjacket tissue matrix showed a statistically significant higher percentage of wound healing with respect to wound area, and clinically significant differences in wound depth and wound volume. This comparison is not performed to demonstrate that the application of the Grafjacket is more effective than sharp debridement. This study is done to help assign a role to the use of Graftjacket matrix in lower extremity wound care.

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Effective Management of Major Lower Extremity Wounds Using an Acellular Regenerative Tissue Matrix: A Pilot Study

Cited by 83 publications

References 9 publications

Outcomes of allogenic acellular matrix therapy in treatment of diabetic foot wounds: an initial experience

Outcomes of allogenic acellular matrix therapy in treatment of diabetic foot wounds: an initial experience

Solubilized extracellular matrix bioscaffolds derived from diverse source tissues differentially influence macrophage phenotype

The use of an acellular dermal regenerative tissue matrix in the treatment of lower extremity wounds: a prospective 16‐week pilot study

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