Combination Use of a Bioresorbable Silver Matrix and NPWT Following Wide Excisional Debridement of a Pilonidal Cyst

In a 2021 poster abstract submitted to SAWC Fall, Shannon Payseur, MD, discusses a 23-year-old male patient, who presented with an inflamed nonhealing pilonidal cyst complicated by fistula that was reoccurring and/or open for about four years. The patient received three previous surgeries for smaller or less severe wounds that had an average healing time of nine months. In the patient’s most recent wide excisional debridement, the wound measured 259 cm³. The patient had reported pain at the surgical site, which caused the author to prescribe an analgesic accordingly.

In this case, the author used a bioresorbable antimicrobial silver matrix (Microlyte Matrix; Imbed Biosciences) to support the growth of granulation tissue within the open wound, promote reepithelization, and manage the wound’s bioburden. The wound dressing was changed every 2 to 5 days over the period of one month. The wound was treated with the matrix at each dressing change for a total of nine dressing changes. At week two, negative pressure wound therapy (NPWT) was placed on the wound and re-applied every 2 to 5 days until week four.

After one week of the matrix, the patient’s wound closed by 15%, and by week two, their wound closed by 50%. NPWT was added to the treatment plan one week after 50% wound closure was noted. The authors reported that NPWT helped heal the patient’s wound by 80%, and remained at 80% by week four, measuring 54 cm³. The patient experienced decreased pain at the surgical site without the wound becoming infected. Within four weeks, the use of the matrix and NPWT had jump started the patient’s healing process, which led to the patient’s wound volume and pain level to decrease by 80%.

The author states in conclusion, “The Matrix therefore shows promise as an adjunct therapy in treating chronic pilonidal cysts.”

Poster Citation

Payseur S. Combination use of a bioresorbable silver matrix and NPWT following wide excisional debridement of a pilonidal cyst. Presented at: Symposium on Advanced Wound Care Fall; Las Vegas, NV; October 29-31, 2021.