In this section, you have learned:
- In preparation for INTEGRA™
Matrix Wound Dressing application, the wound
is debrided or excised to viable tissue and INTEGRA™
Matrix Wound Dressing is applied. Over the next
2-4 weeks, the INTEGRA scaffold is remodeled while simultaneously
degrading the collagen-GAG matrix. After INTEGRA™
Matrix Wound Dressing has been replaced by host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™
Matrix Wound Dressing. Meticulous hemostasis
must also be achieved to prevent hematomas or excessive
fluid accumulation. To ensure intimate contact with
INTEGRA™ 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. 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™ 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™
Matrix Wound Dressing by preventing shearing
and dislodgement, while still enabling routine visual
examination. Dressings should be built in layers to
protect the INTEGRA™ Matrix
Wound Dressing site from shear and infection.
When removing dressings to inspect INTEGRA™
Matrix Wound Dressing sites, care should be taken
to avoid dislodgement. You should inspect INTEGRA™
Matrix Wound Dressing 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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COURSE, select a new section from the course outline on
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