Using a 3D Electrospun Synthetic Polymer Matrix for Limb Salvage

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My name is Simon Tabchi. I'm a fellow of the American College of Foot and Ankle Surgeons. I currently practice in Lehigh Valley, Pennsylvania. I'm part of PA Foot and Ankle Associates, which is a division of PACE, and we are a private practice, podiatry group in the Lehigh Valley area.
 
Q: Can you share some details of your recent case series using a 3D electrospun synthetic polymer matrix?
 
So at the wound care conference, we have 2 posters. One of the posters is a complex, venous leg ulceration in a patient who actually had these wounds for almost about year and a half to 2 years before I inherited her. And the 2nd poster is more of also complex wounds in more of the diabetic population. And, you know, a lot of the patients in that in that study are very complex, noncompliant diabetics. Average a1c is almost close to 10. So, you know, that battle of trying to get their wounds to heal and trying to get, you know, their diabetes under control, because of how much it affects their healing potential, we, you know, we had to look at different ways in order to try to heal these patients.
 
And in both studies, we used the Phoenix Wound Matrix. What we found from the studies is that within 4 weeks, we had, a, you know, a decrease in the dimension of the wounds by almost 2 thirds. By the 8 week mark, 66% of the wounds were actually healed and almost full closure by 12 weeks. The average application for these complex wounds is about 2 to 5 of the Phoenix Wound Matrix. My patients in the diabetic foot study, closer to about 3.
 
So that's I mean, that's very significant for a lot of us. You know, we were always looking for ways to treat our patients and treat them the best way we can the most efficient way that we can. And what we have seen from this Phoenix Wound Matrix is we're actually able to do that. And in order to understand, you know, how are we able to do that, well, we need to understand what is this Phoenix Wound Matrix. The Phoenix Wound Matrix, it's a synthetic.
 
So, you know, a lot of products on the market are allogeneic or xenogenic. This is a synthetic, and it's an electrospun microporous polymer. The way that it's made, it's an electrical eld between a metallic needle and a polymeric solution with a ground collector. And what happens is the synthetic gets stretched. And when it gets stretched, it gets stretched into nanofibers that make up this synthetic.
 
And the really cool thing about it is that finished wound matrix kind of works on 2 levels. So under a microscope, the wound matrix looks like extracellular matrix, which is our normal skin. And from a different from a different aspect, you know, it helps us To drop the pH of these wounds and to control the environment of these wounds. You know? And the good thing about the Phoenix Wound Matrix is that it is FDA approved.
 
It's FDA approved for both acute and chronic wounds, for partial full thickness wounds as well as burns. And, you know, we understand from the Phoenix Wound Matrix, it's workability and how it works in controlling the pH level. You know, pH level in chronic wounds is very, very important. The higher the pH, the harder it is to heal wounds and the more chronic they become. An in vitro study that was performed for the phoenix wound matrix showed that it was able to drop The pH within about 72 to 78 hours from about 7.5 to 5.9 and continued to work for 2 weeks, we're at the 2 week mark.
 
The pH level was already at about a 4. And the way that it does this is that the Phoenix wound matrix is made from, polymers, and they're acidic polymers. And the polymers are polyglycolic acid and polylactide cocaprolactone. And what they do is as they hydrolyze, they hydrolyze into weak acids, which are the glycolic acid, lactic acid, and caproic acid. And as they do that, they're able to allow us to drop the pH level of these wounds, which then allows us to control the microburden and the environment around it.
 
As well, these polymers are known naturally by the body, and they're known by the body to increase cell proliferation, increase cell adhesion, increase angiogenesis, and therefore, promote epithelialization in order to really get these wounds to heal. Significantly.
 
Q: How have the results of your series impacted your wound care practice?
 
You know, when we're treating wounds and we're trying to get them out of their chronic state, well, we need to understand what exactly is going on in a chronic wound. What's going on in that state? Studies have shown that, when wounds are in their chronic state, the average pH is about 7.1 to 8.9.
 
So it's in an alkalinic state. When wounds are in an alkalinic state, you're decreasing the release of oxygen. You decrease epidermolysis, and you decrease angiogenesis. So how do we get these wounds out of that chronic state into more of an acute phase so that we can properly treat it and properly address it? And that's where the Phoenix Wound Matrix comes into play.
 
You know, like I said, that in vitro study allows us to drop that pH level to more of an acidic state where, we are controlling the actual microenvironment around it. When you decrease the pH, you're allowing for the release of oxygen. You're allowing for the epithelialization and further closure of these wounds, which we have seen with, use of the Phoenix Wound Matrix.
 
You know, I've been out in practice for about 7 years, but I love limb salvage. I love dealing with wounds. I like the complexity of it, and I like trying to figure out how do we make these patients better.
 
And what Phoenix Wound Matrix has done for me is it's given me a predictability value. You know, within that 2 weeks, the difference in how the wounds look and the amount of granulation tissue that's now present has been significant. And then If we needed to add the 2nd or 3rd application, we're seeing that same thing, and it's allowing us to treat and heal these patients at a quicker rate than if we were using any other type of products. You know, there's always been a lot of products on the market.
 
There's a lot of allergenic products. There's large xenogenic products. The problem is that some patients get reactions from this, and that's what kind of deterred me from using a lot of products because of seeing this in patients. Well, the Phoenix Wound Matrix is a synthetic, so you're bypassing all that. As well, you know, the area where I work, there's a large mix of religion, call ethnicity, and people have different beliefs.
 
So I can't just go putting products that are made of pig or cow or whatever it may be on patients secondary to their religious backgrounds or their ethnic backgrounds or whatever beliefs that they may have. So by using the fee the wound matrix, I don't have to worry about that. So I've been able to utilize it, and aid me in to really trying to heal these patients.