Eyelid reconstruction: Porcine matrix offers new xenograft for individuals with large, difficult-to-treat lesions

The matrix is a skin substitute product originated from porcine (pig) urinary bladder made use of extensively in general surgical treatment as well as to deal with burns.

Making use of this product has currently been extended to include periorbital restoration and is an effective alternative to granulation, skin grafts, or flaps in selected patients.

” Our skin’s dermal extracellular matrix is an intricate meshwork of healthy proteins and carbohydrates, the main healthy protein being collagen,” a doctor working in the area claimed. “Collagen is supported by glycosaminoglycans and is woven together with proteoglycans and affixed to cells with integrin and also fibronectin.”
These dermal elements provide strength as well as structure to the skin and permit recovery to take place.

How it works
The product provides a source of naturally occurring growth factors, numerous types of collagen, laminin, fibronectin, proteoglycans, and elastin.
“Theoretically, the product works as a bio-scaffold that maintains and supports healing by allowing remodelling of site-appropriate functional tissue to encourage healing while avoiding the progress of scar tissue,” the doctor stated. “Clinical Research studies have revealed that the product actually also lowers dermal fibrosis.”
Matristem is a xenograft, a material derived from animal tissue. Various other commercially available xenograft products are those produced from bovine collagen, shark, as well as silicone; from porcine jejunum; and from bovine tendons.

In contrast, allografts, are derived from human cells.

Periocular reconstruction experience with the matrix
The doctor’s first experience included reconstructive treatments in 17 patients (11 women, 6 men), specifically, 14 with periocular Mohs defects, as well as 1 each with epidermolysis bullosa, cicatricial ectropion, and a skin graft donor site. The patients varied in age from 36 to 84 years.
The doctor defined some illustrative situations. A 47-year-old patient had periocular epidermolysis bullosa refractory to conventional wound treatment over 2 years. Epidermolysis bullosa is characterised by a defect in laminin.

The doctor chose to utilize a product in which laminin is 1 of the glycoproteins provided. The lesions healed after application of the urinary bladder matrix.

Another instance included a 66-year-old patient with a huge, superficial Mohs defect of the eyebrow. At 6 weeks post-application, the skin was completely recovered as well as brow cilia were growing.
These patients revealed substantial improvement of their skin lesions. The optimal areas for use of this xenograft product are medial as well as lateral canthal defects, preauricular skin graft donor sites, and also the superior rim and also brow defects.

More experience with the product has actually revealed that defects in the central lower eyelid need extra procedures such as lid lightening. Eyelid rim defects have not been examined.

Standard application procedure
The doctor currently has experience with greater than 40 patients and has standardised his application procedure. The material is offered as Wound Matrix sheets of different sizes as well as thicknesses and as Micro-Matrix powder.
First, the powder is dampened with a small amount of sterilized erythromycin ointment and normal saline to develop a workable paste.

After a sterile preparation, the paste is made use of to cover or fill the defect as well as a 1-ply sheet is sutured over the defect with a 6-0 chromic suture. The sheet is bolstered as well as patched for 2 weeks.

After bolster removal, antibiotic ointment is applied to the location daily for 2 or more weeks. A light covering such as a plaster is utilized for safety. The treatment requires about 10 to 15 minutes.

The doctor reported that healing accompanied marginal scarring. No episodes of rejection, allergy, or infection had actually occurred.
“This is a quick and also easy preliminary application which can be used without inordinate hassle, however close follow-up is required,” he claimed. “Also, after 2 weeks of the bolster and also patch, the defect looks ‘raw’ as well as patients require to be comforted about their healing and looks. Most patients had some mild issues concerning the long-lasting covering.”
“This product is quick, simple to make use of, as well as relatively low-cost,” the doctor ended. “The procedure can be easily done in an office setting with local anaesthetics and also no sedation.”

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