Early Experience Using 3D Electrospun Polymer Matrix in Open Wounds

Collagen and Extracellular Matrices (ECMs) are useful in wound healing.  Most cellular tissue-based products (CTPs) are biologic but synthetic (non-biologic) CTPs allow cellular regeneration and skin formation.  3D-electrospun polymer matrix (EPM) received FDA clearance in 2018.  This study reviews initial experience using EPM for wound care.Debridement of wounds occurred before measurement.  EPM was cut to match the defect and fenestrated before direct application.  Dressing changes occurred at 3-7 days with EPM reapplied when deterioration occurred.EPM was applied to 22 wounds (13 acute/9 chronic) from 12 patients with average wound 9.79 cm_.  Wound etiologies included VLU (4), VLU with foreign body (1), ischemic (2), chronic sacral decubitus (1), chronic neuropathic pressure (1), chronic post-surgical pilonidal cyst (1), Pseudoepitheliomatous Hyperplasia (1), and Tophaceous Gouty Bursitis.  Eight wound healed after 15 applications (8 for the PEH) for an average of 4.8 weeks.  Six wounds are currently under therapy (1-4 weeks) with a 64% reduction.  Tow patients with chronic wound tracts changed therapy:  1 week 64% volume reduction and 2 weeks with 26% volume reduction.  The patient with suspected foreign body (33% SAR at 2 weeks) was lost to f/u after refusing tagged WBC scanning.  One 87-year old patient with critical AS elected for Hospice care and expired shortly after initial application.  PEH wound had been refractory to multiple CTP therapies.  Change to UV therapy and EPM achieved healing with 8 applications (14 weeks).  The neuropathic pressure ulcer had 89% SAR at 4 weeks.Early experience with EPM demonstrated excellent healing for a variety of wounds.  There was response in tunneling wounds but the thin matrix made filling of the tract suboptimal.  Early adherence of EPM was common with robust healing noted.  Optimal time for reapplication needs to be studied further.