Wound Bed Preparation
  Post-Op Care

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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 After INTEGRA™ Meshed Bilayer Wound Matrix has been replaced by host tissue, a thin epidermal autograft 0.004-0.006 inches (0.1016 - 0.1524 millimeters) may be applied.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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