In this section, you have learned:
- In preparation for INTEGRA™
Bilayer Matrix Wound Dressing application, the
wound is debrided or excised to viable tissue and INTEGRA™
Bilayer Matrix Wound Dressing is applied. Over
the next 2-4 weeks, the dermal layer is remodeled while
simultaneously degrading the collagen-GAG matrix. The
biodegradable template induces organized remodeling
of tissue by the body. After the silicone layer is removed,
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™
Bilayer Matrix Wound Dressing. Meticulous hemostasis
must also be achieved to prevent hematomas or excessive
fluid accumulation. To ensure intimate contact with
INTEGRA™ Bilayer Matrix
Wound Dressing 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. You can mesh sheets
1:1 through a "non-crushing" mesher (e.g.
Brennen®) but do not expand. 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™ Bilayer
Matrix Wound Dressing 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™ Bilayer Matrix
Wound Dressing by preventing shearing and dislodgement,
while still enabling routine visual examination. Dressings
should be built in layers to protect the INTEGRA™
Bilayer Matrix Wound Dressing site from shear
and infection. When removing dressings to inspect INTEGRA™
Bilayer Matrix Wound Dressing sites, care should
be taken to avoid dislodgement. You should inspect INTEGRA™
Bilayer Matrix Wound Dressing by checking seams,
interstices, and edges for signs of hematomas, infection,
fluid accumulation, silicone layer separation, 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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