Augmented Flap Reconstruction of Complex Pressure Ulcers Utilizing Nanofiber Surgical Matrix

Flap reconstruction of pressure ulcers offers an important clinical means of decreasing morbidity in hospitalized patients. Current complication rates following pressure ulcer reconstruction utilizing flap coverage are reportedly high as patients commonly possess multiple risk factors for postoperative dehiscence, infection, and ulcer recurrence [1]. A new novel method of treating pressure ulcer wounds has been developed by using a nanofiber surgical matrix* prior to tissue flap reconstruction. The surgical matrix* has nanofiber structure similar to the human extracellular matrix and supports cell ingrowth, retention, and granulation tissue formation.

In this retrospective study, included patients had pressure ulcers who failed other wound therapies and also, had various risk factors. Before treatment, a sharp debridement of the wound margins and wound bed was performed. Next, wounds were treated by applying nanofiber surgical matrix*, prior to flap reconstruction, based on physician assessment of wound status. The primary aim of this case series was to examine and determine whether preparation of pressure ulcers with a novel nanofiber surgical matrix* would reduce the rate of wound healing complications, readmissions, and re-operations following flap reconstruction.

Overall, the patient outcomes showed that nanofiber surgical matrices* were used successfully to treat pressure ulcers with a wound closure rate of 90.9% (10 cases of complete wound closure and one case of 97.2% wound area reduction). Additionally, no complication related to the application of each nanofiber surgical matrix* was reported. Use of nanofiber surgical matrix* allows cellular ingrowth and granulation tissue formation which improves tissue quality and wound site preparation for subsequent operations.

Together, these results suggest that pre-conditioning and/or adherence testing of complex pressure and other ulcers with nanofiber matrix* maximizes the efficiency and success of flap coverage and completes chronic wound closure.

Trademarked Items (if applicable): Restrata, Acera Surgical Inc, St Louis, MO

References (if applicable): 1. Bamba, R., et al., Flap reconstruction for pressure ulcers: an outcomes analysis. Plastic and Reconstructive Surgery Global Open, 2017. 5(1).