3M Tegaderm Matrix Matrix Dressing Matrix Your questions answered
3M Tegaderm Matrix Matrix Dressing Frequently Asked Questions What is Tegaderm Matrix? Matrix is a wound dressing impregnated with polyhydrated ionogens (PHI) ointment which balances the chronic wound environment accelerating the healing process. PHI is composed of a mixture of metal ions in a citric acid buffered, hydrophilic matrix. What are matrix metalloproteinases (MMPs) and how do they influence the wound healing process? MMPs are a specific group of zinc-containing proteolytic enzymes. They play an important role in remodelling the extracellular matrix during wound healing in both degradation and regeneration and in supporting epithelialization. During normal wound healing there is a balance between the clearing of the damaged tissue and the building of the new tissue. However, in chronic wounds an imbalance exists in this process, resulting in slower or arrested wound healing. Many research studies have identified raised levels of MMPs in chronic wounds. Prolonged high levels of MMPs can destroy new tissue which impairs the wound s ability to heal. TIMP (tissue inhibitors of MMP) are the natural inhibitors of MMPs. In normal wound healing the levels of TIMPs and MMPs are balanced, allowing the new wound structure to be laid down in a regular, progressive manner. In chronic wounds there exists an imbalance between TIMPs and MMPs which leads to an unstable extracellular matrix and impedes the wound healing process. In order to accelerate wound healing the balance of MMPs and TIMPs needs to be restored. There are many different types of MMPs but MMPs 2 and 9 are of greatest importance to wound healing and are often overexpressed in hard-to-heal wounds. How does Matrix inhibit an overproduction of MMPs? The metal ions in Matrix inhibit the production of MMPs at the cellular level, thus creating balance between the activity of tissue inhibitor metalloproteinases (TIMPs) and the relevant MMPs. What is Matrix made of? Matrix consists of an acetate carrier impregnated with PHI ointment which consists of a blend of metal ions (rubidium, calcium, zinc and potassium), 20% water carried in polyethylene glycol (PEGs) in a citric acid buffer. The acetate carrier is made of cellulose acetate which allows passage of exudate and is non-fibre shedding. PEGs PEGs allow delivery of the polyhydrated ionogens (PHI) into the wound bed, activating delivery of the metal ions. PEGs are hydrophilic, requiring warmth and moisture to activate the release of the formula into the wound bed. In the presence of exudate a gradual release of the PHI formulation into the wound is stimulated, allowing the metal ions to enter the fibroblast cells.
Metal ions and how they work There are four metal ions in the PHI ointment: rubidium, calcium, zinc and potassium. Production of MMP-2 by fibroblasts will be down-regulated by the metal ion formulation. Rubidium Rubidium is the first ion to enter the cell membrane, opening up a channel for the other ions to pass through. Calcium Calcium inhibits the production of MMPs. Zinc Zinc inhibits the production of MMPs and is required for tissue regeneration. Potassium Potassium depolarizes cell membranes as it switches the protein manufacturing and inhibits the MMP production. Potassium is also required for tissue regeneration. Citric acid and how it works In the initial phase of wound healing, ph plays an important role in the synthesis of neutral complexes facilitating transport of metal ions over the cell membrane. In normal wound healing the wound ph is slightly acidic (ph5), whereas it is neutral to alkaline in many chronic wounds. A high ph has been found to slow cell proliferation, thus retarding wound healing. The rate of wound healing has been found to increase when reducing the ph of the wound 1 with an effective buffer such as citric acid. When should I use 3M TM Matrix? Matrix is indicated for use with chronic non-infected wounds, including: Diabetic foot ulcers Leg ulcers Pressure ulcers In chronic non-healing wounds with duration of more than six weeks as it: Normalizes the micro-environment of the wound 2,3,4 Regulates the MMP imbalance 5 Facilitates re-epithelialization, thus promoting wound closure 2 Supports faster healing of chronic wounds 6 It is ideal for wounds that refuse to heal and that are not responding to other wound care treatments after a period of four to six weeks. When shouldn t I use Matrix? When dry necrotic tissue is present Clinically infected wounds A known allergy to any of the ingredients
Can 3M TM Matrix be used in conjunction with compression bandaging? Yes, Matrix can be used beneath compression bandaging. A secondary dressing will be required to maintain a moist wound healing environment. Can Matrix be used together with active dressings such as those containing silver, iodine or honey? Matrix is not indicated for use in infected wounds and we currently have no evidence supporting its use together with other active dressings. How do I prepare the wound prior to using Matrix? Follow local guidelines and protocols for wound bed preparation prior to using Matrix. How do I use Matrix? Cleanse the wound according to local guidelines/protocols Apply Matrix directly to the wound ensuring intimate contact is made with wound bed Always apply a secondary dressing to Matrix to maintain a moist wound healing environment for moderate to high-exuding wounds: 3M Tegaderm Foam Dressing (adhesive or nonadhesive) for low to moderately-exuding wounds: 3M Tegaderm + Pad Film Dressing with Non-Adherent Pad for low to non-exuding wounds: 3M Tegaderm Film Dressing To protect the peri-wound use 3M Cavilon No Sting Barrier Film at each dressing change At dressing change, remove secondary dressing and gently lift Matrix away from the wound In wounds where exudate levels have significantly diminished, Matrix may be moistened to aid gentle removal. If desiccation has occurred review secondary dressing suitability Can Matrix be cut? Yes, Matrix may be cut to fit the wound however, folding the dressing is also acceptable practice, depending on wound location. Overlaying on surrounding skin will not harm the skin or affect tissue integrity. Choose whether to cut or fold based on wound characteristics and best solution for patient comfort. How often should Matrix be re-applied? Matrix should be re-applied at every dressing change. Clinical evaluations to date demonstrate improved healing in patients having daily, twice weekly and weekly dressing changes. 7 It is important to note that in the initial stages more frequent dressing applications will maximize delivery of metal ions and thus accelerate healing outcomes. How long will it take before I notice any improvement? This is dependent on the frequency of dressing change. A noticeable improvement in wound condition should be seen in two to three weeks. Are there any side effects reported by using Matrix? No side effects have been reported however Matrix should not be used on patients with known sensitivity to acetate or PHI.
Ordering information 3M Tegaderm Matrix Dressing Catalogue No. Size Dressings/Box Boxes/Case 90900 2 in x 2 3 /8 in 10 24 5 cm x 6 cm 90901 3 1 /8 in x 4 in 5 24 8 cm x 10 cm 3M Tegaderm Foam Adhesive Dressing Catalogue No. Pad Size Overall Each/ Boxes/ Dressing Size Box Case 90610 (square) 2 in x 2 in 3 1 /2 in x 3 1 /2 in 10 4 5 cm x 5 cm 8.8 cm x 8.8 cm 90611 (oval) 2 1 /2 in x 3 in 4 in x 4 1 /2 in 10 4 6 cm x 7.6 cm 10 cm x 11 cm 90612 (square) 4 in x 4 in 5 1 /2 in x 5 1 /2 in 10 4 10 cm x 10 cm 14 cm x 14 cm 90613 (oval) 4 in x 4 1 /2 in 5 1 /2 in x 6 in 5 6 10 cm x 11 cm 14 cm x 15 cm 90616 (oval) 5 1 /2 in x 6 3 /4 in 7 1 /2 in x 8 3 /4 in 5 3 14 cm x 17.1 cm 19 cm x 22.2 cm 90619 (heel) 3 in x 3 in 5 1 /2 in x 5 1 /2 in 5 4 7.6 cm x 7.6 cm 14 cm x 14 cm 3M Tegaderm Foam Dressing (nonadhesive) Catalogue No. Size Each/Box Boxes/Case 90600 2 in x 2 in 10 4 5 cm x 5 cm 90601 4 in x 4 in 10 4 10 cm x 10 cm 90602 4 in x 8 in 5 6 10 cm x 20 cm 90603 8 in x 8 in 5 6 20 cm x 20 cm 90604 Fenestrated 10 4 3 1 /2 in x 3 1 /2 in 8.9 cm x 8.9 cm 90605 Roll 1 Roll/Pkg 6 Rolls/Case 4 in x 24 in 10 cm x 60 cm
Ordering information 3M Cavilon No Sting Barrier Film Catalogue No. Applicator Size Items/Box Boxes/Case 3343E 1.0 ml swab 25 4 3344E 1.0 ml wipe 30 6 3345E 3.0 ml swab 25 4 3346E 28.0 ml spray bottle 12 1 3M Cavilon Durable Barrier Cream Catalogue No. Applicator Size Items/Box Boxes/Case 3392E 92 g tube (3.3 oz.) 12 1 3391E 28 g tube 12 1 References: 1. B Greener, AA Hughes, NP Bannister and J Douglass. (2005). Proteases and ph in chronic wounds. Journal of Wound Care Vol. 14, No 2: 59-61. February 2005. 2. Hoekstra M, Pirayesh A. (2003). Poly Hydrated Ionogens regulate Matrix Metalloproteinases Expression and Reactive Oxygen Species in Recalcitrant Wounds European Tissue Repair Society Congress, September 2003. 3. Körber A, Freise J, Rietkötter J, Grabbe S. Dissemond J. (2006). Erfolgreiche Behandlung therapierefraktärer chronischer Wunden mit DerMax (Successful treatment of therapy-refractory chronic wounds with Tegaderm Matrix). Zeitschrift fur Wundheiling 6; 310-314. 4. van den Berg AJJ, Halkes SBA, Quarles van Ufford HC, Hoekstra MJ, Beukelman CJ. (2003). A novel formulation of metal ions and citric acid reduces reactive oxygen species in vitro. J Wound Care 12(10). 5. Monroe S, Sampson EM, Popp MP, Lobman R, Schultz GS. (2005). Effect of Polyhydrated Ionogens (PHI) on Viability and Matrix Metalloproteinase Levels in Cultures of Normal and Diabetic Human Dermal Fibroblast. Poster Presentation WHS. Chicago. May 2005. 6. S Monroe, & G Schultz. (2005). Effect of Polyhydrated Ionogen (PHI) on Viability and Matrix Metalloproteinase Levels in Cultures of Normal and Diabetic Human Dermal Fibroblasts. Poster presentation, WHS, Chicago, May 2005. 7. Hampton S, Young S, Kerr A, King L. (2006). An observational study of the use of a polyhydrated ionogen impregnated dressing (DerMax) in the treatment of wounds. Poster presentation, EWMA, Prague, Czech Republic. May 2006. PHI: Polyhydrated ionogens 3M Canada P.O. Box 5757 London, ON N6A 4T1 Canada 3M Medica D-41453 Neuss Germany 1 800 364-3577 www.3m.com/ca/healthcare 3M and Tegaderm are trademarks of 3M. Used under license in Canada. 2007, 3M. All rights reserved. 0710-CP-30048-e