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Case Study
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Experience with a novel bovine dermal-derived extracellular matrix* to heal diabetic foot wounds: a series of 3 Michael Miller, DO, FACOS, FAPWCA, CWS, Cheryl McDaniel, LPN Extracellular matrix consists of attachment proteins, signaling molecules, structural proteins, and a collagen scaffold that provides the tissue with an organized structure. The scaffolds themselves have attachment sites for cells and for substances that are secreted by cells, including signaling molecules, important for inducing growth, differentiation, and repair. As a tissue is formed, cells synthesize and secrete cell products that are required for the tissue's growth, architecture, and specialization. Collagen molecules, which assemble into a polymerized fiber scaffold, are among the first to be secreted. They capture and immobilize other cell products and together they make up the extracellular matrix. Primatrixª (TEI Biosciences, Inc.) is a strong, highly biocompatible, acellular collagen matrix derived from fetal bovine dermis. It is cell friendly, quickly vascularized and provides an environment to facilitate new tissue growth Three cases are presented of foot wounds in three different diabetic patients (an exposed distal phalangeal bone with osteomyelitis; a plantar based metatarsal wound; a large digital/metatarsal amputation wound) that were poorly responsive to usual aggressive therapies employed at the Wound Healing Center of Terre Haute, Indiana. While no product is a panacea, Primatrixª offers a novel approach to treating these difficult wounds that should be considered in diabetic foot wounds that appear recalcitrant to usual therapy *PrimatrixTM, TEI Biosciences, Inc Longaker MT, Whitby DJ, Adzick NC, et al. Studies in fetal wound healing VI, Second and early trimester fetal wounds demonstrate rapid collagen deposition without scar formation. J Pediatr Surg. 1990;25:63Ð68 Knudsen BS, Harpel PC, Nachman RL. Plasminogen activator inhibitor is associated with the extracellular matrix of cultured bovine smooth muscle cells. J Clin Invest. 1987;80(4):1082Ð1089. Bello YM, Falabella AF, Eaglstein WH. Tissue-engineered skin. Current status in wound healing. Am J Clin Dermatol. 2001;2(5):305Ð313 Varedi M, Tredget EE, Ghahary A, Scott PG. Stress-relaxation and contraction of a collagen matrix induces expression of TGF-beta and triggers apoptosis in dermal fibroblasts. Biochem Cell Biol. 2000;78(4):427Ð36. |
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