(CS-025) Augmenting Pressure Injury Flap Reconstruction with an Ovine Forestomach Matrix Graft: A Retrospective Case Series

Introduction: The burden of pressure injuries (PI) remains a substantial problem with over 1 in 10 adults patients admitted to hospitals affected with PI’s (Li, Lin et al. 2020). As of 2011 it was estimated that the cost of treating a stage IV PI and its related complications was $129,248. Additionally, the average 6 month post operative healing rates for a stage IV PI is 31-34% and the post operative complication rate after flap reconstruction is reported to be 58.7% (Bamba, Madden et al. 2017). Herein we present the use of an ovine forestomach matrix (OFM) graft in PI reconstruction. OFM is an intact extracellular matrix graft that has demonstrated an ability to modulate tissue proteases (Negron, Lun et al. 2012), promote angiogenesis (Irvine, Cayzer et al. 2011) and is resilient in contaminated wounds (Chaffin and Buckley 2020, Desvigne, Bauer et al. 2020, Chaffin, Dowling et al. 2021, DeNoto, Ceppa et al. 2021). The author hypothesizes that the addition of OFM would decrease post operative complications and healing times seen in PI reconstruction.

Methods: This is a retrospective case series analyzing six cases in which OFM graft⁺ was utilized as part of PI reconstruction. All patients had a closed incision negative pressure wound therapy device placed. Patients were followed up with after application and monitored for any complications such as surgical wound dehiscence, hematoma, seroma, flap necrosis or infection.

Results: Six patients presented with a stage IV PI. All six patients underwent a flap surgical reconstruction with the use of an OFM graft⁺ as an implant. All six flap reconstruction patients had healed surgical incisions with no post operative complications.

Discussion: OFM may assist in the accelerated healing of PI’s and lower the complication rate with flap closure. Further studies are needed to expand on this pilot experience of adding OFM to the reconstruction of PI.