In this section, you have learned:
- In preparation for INTEGRA™
Meshed Bilayer Wound Matrix application, the
wound is debrided or excised to viable tissue and INTEGRA™
Meshed Bilayer Wound Matrix is applied. Over
the next 2-4 weeks, the INTEGRA™ scaffold is remodeled
while simultaneously degrading the collagen-GAG matrix.
After INTEGRA™ Meshed Bilayer
Wound Matrix has been replaced by host tissue,
a thin epidermal autograft 0.004-0.006 inches (0.1016
- 0.1524 millimeters) may be applied. As shown, engraftment
and confluence of the epidermal graft may complete the
wound closure in about 30 days.
- In section 2, wound bed preparation,
we stressed that a prepared wound bed must be free from
contamination and infection. All necrotic and devitalized
tissue must be removed. You must achieve an adequate
vascular supply prior to the application of INTEGRA™
Meshed Bilayer Wound Matrix. Meticulous hemostasis
must also be achieved to prevent hematomas or excessive
fluid accumulation. To ensure intimate contact with
INTEGRA™ Meshed Bilayer
Wound Matrix the wound bed must be uniform and
flat. The wound bed must be dry with no signs of bleeding.
You should achieve level tissue planes and when necessary,
marsupializing edges to avoid large step-offs between
the wound bed and normal skin.
- In section 3, application, you learned
to estimate the number and size of sheets, as well as
prepare the product for application. Do not try to move
or "float" sheets like a STSG, instead, lift
sheets up and reposition. Place sheets on prepared wound
bed, secure parallel to inside edge of wound bed and
trim excess. Fix sheets independently and/or secure
adjacent sheets together to minimize gaps, reducing
granulation tissue formation. It is recommended that
dressings be built in layers while checking under dressings
frequently.
- In section 4, post-op care, the appearance
of the INTEGRA™ Meshed Bilayer
Wound Matrix will vary. The rate and progression
of the color change depends on the patient and rate
of healing. Generally, the color will change through
a progression from red to pink to orange/peach to vanilla.
The goal of the dressings is to protect the INTEGRA™
Meshed Bilayer Wound Matrix by preventing shearing
and dislodgement, while still enabling routine visual
examination. Dressings should be built in layers to
protect the INTEGRA™ Meshed
Bilayer Wound Matrix site from shear and infection.
When removing dressings to inspect INTEGRA™
Meshed Bilayer Wound Matrix sites, care should
be taken to avoid dislodgement. You should inspect INTEGRA™
Meshed Bilayer Wound Matrix by checking seams,
interstices, and edges for signs of hematomas, infection,
fluid accumulation, and areas of non-take on a regular
basis. Your visual inspection regimen should include
recognition of healing wound tissue as well as the ability
to identify the various complications that may arise.
Early and swift intervention of these complications
will help in the successful take of the product.
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