Alexis Lanteri Parcells, M.D Ian C. Hoppe, M.D. Brenon Abernathie, M.D. Ramazi O. Datiashvili, M.D. Ph.D University of Medicine and Dentistry of New Jersey Division of Plastic Surgery Department of Surgery Newark, NJ USA

1. THE USE OF URINARY BLADDER
MATRIX (ACELL) IN THE TREATMENT OF
COMPLICATED OPEN WOUNDS
Alexis Lanteri Parcells, M.D
Ian C. Hoppe, M.D.
Brenon Abernathie, M.D.
Ramazi O. Datiashvili, M.D. Ph.D
University of Medicine and Dentistry of New Jersey
Division of Plastic Surgery
Department of Surgery
Newark, NJ USA

2. Background
• Annual wound care cost to the US healthcare system is
more than $20 billion
• Management of complicated open wounds is a challenge
when reconstructive options are not applicable
• Cellular and molecular research conducted by Badylak in
2002 demonstrated that scaffolds derived from urinary
bladder matrix provide a biocompatible material that
allows inductive tissue remodeling and wound closure

3. Urinary Bladder Matrix (UBM)
•
•Core Structure: bimodal surface
• Epithelial basement membrane
• Lamina propria
• Growth factors
•Healing Response
• Autologous progenitor stem cells
• Chemotactic and mitogenic activity
• Antimicrobial activity
• Site-specific tissue remodeling

4. Material & Methods
• 5 Patients
• Weekly dressing changes
• Mean length of treatment: 20 weeks
• Result of treatment: 100% wound healing

5. Case Presentation
A 61-year-old woman sustained a severe crushing injury to her right knee.
At an outside institution, the wound was debrided and patella removed.
The patient developed a large open wound of the anterior knee with exposed knee joint.
A gastrocnemius muscle transfer and TRAM were attempted and both failed.
VAC therapy alone was attempted and was unsuccessful.
The patient developed occlusion of her SFA and acute DVT, which precluded further reconstruction.
The patient was told she may need an above-the-knee amputation.
After consultation and evaluation at UMDNJ University Hospital, we managed the wound by application of
Acell UBM in combination with VAC therapy at this initial stage

6. In 8 weeks
Case Presentation

7. In 16 weeks
VAC Therapy Discontinued
Case Presentation

8. In 24 weeks
The wound completely closed
Case Presentation

9. Conclusions
• Our experience shows urinary bladder matrix to be an
effective method in management of complicated open
wounds in selected cases
• Further studies need to be implemented to confer this
conclusion

10. References
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2002;324(7330):160–3
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2002; 13: 377-83
• Brown B, Lindberg K, Reing J, et al. The basement membrane component of biologic scaffolds
derived from extracellular matrix. Tissue Eng. 2006 Mar; 12(3):519-26.
• Hodde JP, Ernst DM, and Hiles MC. An investigation of the long-term bioactivity of endogenous
growth factor in OASIS wound matrix. J Wound Care 14(1), 23, 2005.
• Hodde J. Naturally occurring scaffolds for soft tissue repair and regeneration. Tissue Eng
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• Beattie A, Gilbert TW, Guyot J, et al. Chemoattraction of progenitor cells by remodeling
extracellular matrix scaffolds. Tissue Eng. Part A. May 2009, 15(5): 1119-1125.
• Reing JE, Zhang L, Myers-Irvin J, et al. Degradation products of extracellular matrix affect cell
migration and proliferation. Tissue Eng Part A. 2009 Mar;15(3):605-14.
• Brennan EP, Reing J, Chew D, et al. Antibacterial activity within degradation products of biological
scaffolds composed of extracellular matrix. Tissue Eng. 2006 Oct; 12(10):2949-55.
• Gilbert TW, Nieponice A, Spievack AR, et al. Repair of the thoracic wall with an extracellular matrix
scaffold in a canine model. J Surg Res. 2007 Oct 18.