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Topic: Current Concepts in Wound Healing

Acellular micronized extracellular matrix

and occlusive dressings for open fingertip

injuries

Stephanie E. Dreifuss , Ronit Wollstein , Stephen F. Badylak , Peter J. Rubin 1
1
1,2
1
1 Department of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA.
2 Department of Orthopedic Surgery, Technion Medical School, Haifa 3200003, Israel.
Address for correspondence: Prof. Ronit Wollstein, Department of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh,
PA 15261, USA. E‑mail: ronitwollstein@gmail.com

Sir, only, pulp and nail bed, or pulp, nail bed, and distal
phalanx. All patients in the series were followed until
Fingertip amputation injuries compromise the sensation,
function, and appearance of the hand. They are often complete wound healing, which occurred within an
exquisitely painful and take a substantial amount of average of 7 weeks.
time to heal, causing significant functional disability. The wound care regimen for all patients involved removal
Conservative management of these injuries may result in of dressings, gentle sterile saline rinse, application
decreased range of motion, hypo‑ or hyperesthesia, loss of additional P‑ECM powder, and redressing with
of pulp contour, scarring, and other long‑term sequelae. [1,2] nonadherent petrolatum gauze and cotton gauze fingertip
In addition, they may prolong patient discomfort with bandage. The P‑ECM was not completely removed with
dressing changes, hindering adherence with wound each dressing change but allowed to form a crystallized
therapy regimens, especially in the presence of multiple layer over the wound.
finger injuries.
All patients rated the comfort of P‑ECM treatment as
Both acellular and cellular bioscaffolds have been 5 on a 5‑point scale, citing a soothing effect upon
employed in conjunction with wound dressing techniques. changing dressings. Ease of use was rated as 4.2 out
These biologically active materials supply extracellular of 5 for patients who had another individual apply the
matrix proteins, deliver growth factors, and recruit treatment, while patients commented on the difficulty of
differentiated cells to the wound site. [3,4] Furthermore, they independently treating and dressing their own fingertip
aim to address the issue of pain associated with debriding wounds. Moreover, patients reported satisfaction with the
dressings. The efficacy of cellular materials is limited by appearance and function of their fingertips in comparison
their reduced shelf life, risk of the immune response, with normal digits. All patients noted a subjective recovery
increased regulation and high cost. Acellular materials, of pressure sensation, the light touch, and temperature
however, do not face these limitations. sensation, comparable to their uninjured digits. There
were no complications associated with the use of P‑ECM
We present a series of 8 patients (6 males and 2 females, in our series.
average age: 40.8 ± 18.8 years) with fingertip amputations
treated with Particulate Extracellular Matrix, or The P‑ECM powder has an advantage of being
P‑ECM (ACell Inc., Columbia, MD), an acellular, sterile, applied every other day. Furthermore, application and
porcine‑derived, naturally occurring, lyophilized and maintenance are simple and comfortable for patients.
extracellular matrix material. There were 11 fingers
treated. Injuries in these patients involved fingertip pulp
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How to cite this article: Dreifuss SE, Wollstein R, Badylak SF,
Rubin PJ. Acellular micronized extracellular matrix and occlusive
DOI: dressings for open fingertip injuries. Plast Aesthet Res 2015;2:282-3.
10.4103/2347-9264.156994
Received: 23-11-2014; Accepted: 03-01-2015

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