Clinical Presentation: First or Second Dressing Change
GRAFTJACKET® Regenerative Tissue Matrix - Ulcer Repair may demonstrate changes in appearance during the early phases of incorporation. Below are four clinical examples that may be exhibited on the first or second dressing changes. The differences in appearance simply relate to the quality and quantity of microvasculature that enters the graft.

In all cases presented below, the GRAFTJACKET® Matrix incorporated and the ulcer continued to heal uneventfully. It is important to note that the GRAFTJACKET® Matrix has two sides: The dermal or vascular side that is placed down and incorporates into the wound; and the basement membrane side that is exposed to the secondary dressing.
- See Prescribing Information (.pdf) for full information.

THE BASEMENT MEMBRANE SIDE DEMONSTRATES 4 DISTINCT CLINICAL PRESENTATIONS:

Clinical Scenario A
5 DAYS
The GRAFTJACKET® Matrix incorporates and appears as fibrinous tissue during the initial dressing change.

3 WEEKS
The wound was not debrided and dressing changes were continued as usual. What appeared as fibrinous tissue was actually the basement membrane of the graft and was resorbed over time.

Clinical Scenario B
5 DAYS
The GRAFTJACKET® Matrix does not appear to have incorporated and is accompanied by heavy wound exudate, or the graft “lifts off” the wound. However, there is a nice granulation wound bed underneath the graft.

2 WEEKS
The wound was not debrided and dressing changes were continued as usual. In this case the basement membrane simply delaminated or sloughed off leaving the incorporated graft in the wound.

Clinical Scenario C
5 DAYS
The GRAFTJACKET® Matrix has taken in the wound but has a yellow-brown and leathery appearance.

4 WEEKS
The wound was not debrided and dressing changes were continued as usual. The basement membrane in this case has dried out and was resorbed over time.

Clinical Scenario D
14 DAYS
The GRAFTJACKET® Matrix has taken but demonstrates necrotic eschar.

8 WEEKS
Dressing changes were continued as usual. This case demonstrates further dessication of the basement membrane only. An enzymatic debrider may be used to remove the eschar, or the eschar may simply slough off.

NOTE |
Should any graft present with signs of infection, all measures should be taken to eliminate the infection prior to regrafting including debridement and standard infection control.

Images courtesy of:
Stephen Brigido, DPM, Douglas Stoker, DPM and Brock Liden, DPM
™Trademarks and ®Registered marks of Wright Medical Technology, Inc. | ©2005 Wright Medical Technology, Inc. All Rights Reserved. Processed by Lifecell Corporation for Wright Medical Technology, Inc. This product is covered by one or more of the following U.S. patents: 4,865,871, 5,024,830, 5,336,616, 6,652,887