The Use of PriMatrix, a Fetal Bovine Acellular Dermal Matrix, in Healing Chronic Diabetic Foot Ulcers

Kavros, Steven J.; Dutra, Timothy; Gonzalez-Cruz, Renier; Liden, Brock; Marcus, Belinda; McGuire, James; Nazario-Guirau, Luis

doi:10.1097/01.asw.0000451891.87020.69

Cited by 42 publications

(27 citation statements)

References 29 publications

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“…222,223 Currently available nonhuman ECM products with clinical data to support their efficacy include porcine-derived small intestinal submucosa, porcine urinary bladder matrix, bovine dermis, equine pericardium, and sheep (ovine) bladder. [224][225][226][227][228][229][230][231][232][233] Another matrix dressing (Hyalomatrix Ò ; Anika Therapeutics, Inc., Bedford, MA) comprising primarily hyaluronan, one of the main constituents of ECM, has also been studied in Europe as a dermal substitute for use in burns, VLUs, and DFUs. [234][235][236][237] Integra Ò bilayer wound matrix (Integra LifeSciences, Plainsboro, NJ) is a dermal regeneration template in this category (bovine collagen, glycosaminoglycans, and silicone layer) that has primarily been used in burns for a number of years, but is being more frequently used in lower extremity chronic wounds and foot ulcers.…”

Section: Biological and Bioengineered Therapiesmentioning

confidence: 99%

Challenges in the Treatment of Chronic Wounds

Frykberg

Banks

2015

Advances in Wound Care

1,823

1,429

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Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients.Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing.Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based.Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.

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Section: Biological and Bioengineered Therapiesmentioning

confidence: 99%

Challenges in the Treatment of Chronic Wounds

Frykberg

Banks

2015

Advances in Wound Care

1,823

1,429

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“…The acellular collagen scaffold we utilized here (Primatrix, Integra) has been used clinically in prepared human wound beds to support granulation and revascularization of the wound bed before STSG (Kavros et al., 2014, Strong et al., 2016). Unsurprisingly, our results showed that addition of this particular scaffold at the time of grafting impeded graft take, since it may act as a barrier to revascularization of the STSG from the wound bed.…”

Section: Discussionmentioning

confidence: 99%

Adult Human Dermal Progenitor Cell Transplantation Modulates the Functional Outcome of Split-Thickness Skin Xenografts

et al. 2019

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SummaryFollowing full-thickness skin injuries, epithelialization of the wound is essential. The standard of care to achieve this wound “closure” in patients is autologous split-thickness skin grafting (STSG). However, patients living with STSGs report significant chronic impairments leading to functional deficiencies such as itch, altered sensation, fragility, hypertrophic scarring, and contractures. These features are attributable to the absence of functional dermis combined with the formation of disorganized fibrotic extracellular matrix. Recent work has demonstrated the existence of dermal progenitor cells (DPCs) residing within hair follicles that function to continuously regenerate mesenchymal tissue. The present work examines whether cultured DPCs could regenerate dermis within an STSG and improve overall graft function. Adult human DPCs were transplanted into a full-thickness skin wound in immune-compromised mice and closed with a human STSG. At 3 months, human DPCs (hDPCs) had successfully integrated into the xenograft and differentiated into various regionally specified phenotypes, improving both viscoelastic properties of the graft and mitigating pruritus.

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“…PriMatrix ® , Oasis ® , and TissueMend™ are other available collagen matrix-based skin substitutes, which also do not exhibit immunological rejection. PriMatrix ® is a fetal bovine dermal substitute comprising extracellular Type I and III collagen matrix scaffolds and used for the coverage of complex wounds to stimulate vascularization and dermal regeneration [ 122 , 158 , 159 ]. Oasis ® is an acellular dermal substitute fabricated from porcine small intestine [ 7 , 122 , 148 ].…”

Section: Approaches To Avoid Skin Immune Rejectionmentioning

confidence: 99%

Immunological challenges associated with artificial skin grafts: available solutions and stem cells in future design of synthetic skin

et al. 2017

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The repair or replacement of damaged skins is still an important, challenging public health problem. Immune acceptance and long-term survival of skin grafts represent the major problem to overcome in grafting given that in most situations autografts cannot be used. The emergence of artificial skin substitutes provides alternative treatment with the capacity to reduce the dependency on the increasing demand of cadaver skin grafts. Over the years, considerable research efforts have focused on strategies for skin repair or permanent skin graft transplantations. Available skin substitutes include pre- or post-transplantation treatments of donor cells, stem cell-based therapies, and skin equivalents composed of bio-engineered acellular or cellular skin substitutes. However, skin substitutes are still prone to immunological rejection, and as such, there is currently no skin substitute available to overcome this phenomenon. This review focuses on the mechanisms of skin rejection and tolerance induction and outlines in detail current available strategies and alternatives that may allow achieving full-thickness skin replacement and repair.

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The Use of PriMatrix, a Fetal Bovine Acellular Dermal Matrix, in Healing Chronic Diabetic Foot Ulcers

Abstract: The results of this multicenter prospective study demonstrate that the use of PriMatrix integrated with standard-of-care therapy is a successful treatment regimen to heal DFUs.

Cited by 42 publications

References 29 publications

Challenges in the Treatment of Chronic Wounds

Challenges in the Treatment of Chronic Wounds

Adult Human Dermal Progenitor Cell Transplantation Modulates the Functional Outcome of Split-Thickness Skin Xenografts

Immunological challenges associated with artificial skin grafts: available solutions and stem cells in future design of synthetic skin

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