Application Guide for Full-Thickness Wounds

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Application Guide for Full-Thickness Wounds PriMatrix Dermal Repair Scaffold PriMatrix Ag Antimicrobial Dermal Repair Scaffold

Application Guide for Full Thickness Wounds PriMatrix is a unique dermal repair scaffold for the management of the most challenging wounds. PriMatrix is offered in solid, fenestrated, and meshed configurations, in a range of sizes available for burns, trauma, and other challenging partial and full-thickness wounds. Step 1 Prepare Viable Wound Bed The following instructions serve as general guidelines for the application of PriMatrix for full-thickness wounds. 2 As the manufacturer of this device, Integra does not practice medicine and does not recommend this or any other surgical technique for use on a specific patient. The surgeon who performs any implant procedure is responsible for determining and using the appropriate techniques for implanting the device in each patient. Remove all eschar, necrotic, and infected tissue. The tissue bed and margins should contain skin edges with bleeding dermis, subcutaneous fat with punctuate bleeding, scored fascia, and red/pink muscle.

Step 2 Prepare PriMatrix Step 3 Apply and Secure PriMatrix Trim PriMatrix to cover the prepared wound bed with minimal overlap. Hydrate PriMatrix in room temperature sterile saline. Expand and smooth PriMatrix across the wound to ensure intimate contact with the wound bed. Staple or suture PriMatrix to wound edge with minimal overlap. Staple or suture adjacent pieces of PriMatrix. 3

Application Guide for Full Thickness Wounds Step 4 Apply Standard Dressings to PriMatrix Moist Wound Therapy Elastic bandage wrap Absorbent dressings Petroleum-based ointment Petroleum gauze Non-adherent contact layer 1. Apply a non-adherent contact layer directly over PriMatrix. 2. Use appropriate products and secondary dressings to maintain moist wound healing. 3. Use dressings to bolster PriMatrix to ensure contact between PriMatrix and the wound bed. 4

Step 5 Perform Standard Wound Care Moist Wound Therapy Day 1-2: Remove dressings down to petrolatum gauze, replace ointment, absorbent dressings, and elastic bandage wrap. Range of motion can begin. Day 3-5: Remove all dressings down to non-adherent contact layer (remove non-adherent contact layer when PriMatrix has attached to the wound bed). Replace dressings. Day 5+: Remove all dressings, staples and sutures. Gently wash wound, and replace all dressings. 5

Application Guide for Full Thickness Wounds Step 6 Assess Tissue Generation Post-PriMatrix Application Day 4 Day 7 Day 11 6 Day 14 Day 18 Day 21

Step 7 Apply Split-Thickness Skin Graft Prepared Tissue Skin Grafted Tissue Prepare generated tissue for skin graft application using a gentle abrasion system. Harvest a 0.008-0.012 inch thick skin graft. 5 days post-stsg application 19 days post-stsg application 7

Application Guide for Full Thickness Wounds PriMatrix Dermal Repair Scaffold Description PriMatrix is an acellular dermal tissue matrix derived from fetal bovine dermis. The device is supplied sterile in a variety of sizes to be trimmed by the surgeon to meet the individual patient s needs. Indications PriMatrix is intended for the management of wounds that include: Partial and full-thickness wounds Pressure, diabetic, and venous ulcers Second-degree burns Surgical wounds - donor sites/grafts, post-mohs surgery, post-laser surgery, podiatric, wound dehiscence Trauma wounds - abrasions, lacerations and skin tears Tunneled/undermined wounds Draining wounds Contraindications PriMatrix should not be used for patients with a known history of hypersensitivity to collagen or bovine products. Warnings and Precautions Do not expose to chemicals or substances other than sterile, room temperature 0.9% saline. Excessive heat can damage collagen. Do not hydrate in 0.9% saline warmed above room temperature. If, when hydrated, the product shrinks in size, DO NOT use the product as it may be damaged. PriMatrix should be used with caution in regions where an infection exists or is suspected. Treat any existing infection appropriately. Do not resterilize as this may damage PriMatrix. Do not use if the product package is damaged or opened. PriMatrix is for single patient use only. Rinse surgical gloves to remove glove powder prior to touching PriMatrix. Do not use product if past the date of expiration indicated on the product label. Meshing of fenestrated PriMatrix is not recommended. PriMatrix should not be applied directly on third degree burns. 8

Ordering Information PriMatrix Dermal Repair Scaffold Reference Description Configuration 607-001-660 6 cm x 6 cm Solid 607-004-660 6 cm x 6 cm Fenestrated 607-005-660 6 cm x 6 cm Meshed 607-001-880 8 cm x 8 cm Solid 607-004-880 8 cm x 8 cm Fenestrated 607-005-880 8 cm x 8 cm Meshed 607-001-812 8 cm x 12 cm Solid 607-005-812 8 cm x 12 cm Meshed 607-001-112 10 cm x 12 cm Solid 607-001-125 10 cm x 25 cm Solid 607-005-125 10 cm x 25 cm Meshed 607-001-225 20 cm x 25 cm Solid 607-005-225 20 cm x 25 cm Meshed 9

Application Guide for Full Thickness Wounds PriMatrix Ag Antimicrobial Dermal Repair Scaffold Description PriMatrix Ag Antimicrobial is an acellular dermal tissue matrix derived from fetal bovine dermis. The device is supplied sterile in a variety of sizes to be trimmed by the surgeon to meet the individual patient s needs. The Ionic Silver content is intended to prevent microbial colonization of the device. Ionic silver is a broad spectrum antimicrobial. PriMatrix Ag Antimicrobial has been shown in CLSI Disc Susceptibility testing to be effective against a range of bacteria, including: Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Methicillin-Resistant Staphylococcus aureus (MRSA), Enterococcus faecium, Klebsiella pneumoniae, Listeria monocytogenes, Vancomycin-Resistant Enterococcus faecalis (VRE), Acinetobacter baumanni, and Streptococcus pyogenes (Group A). Indications PriMatrix Ag Antimicrobial is intended for the management of wounds that include: Partial and full-thickness wounds Pressure, diabetic, and venous ulcers Second-degree burns Surgical wounds - donor sites/grafts, post-mohs surgery, post-laser surgery, podiatric, wound dehiscence Trauma wounds - abrasions, lacerations and skin tears Tunneled/undermined wounds Draining wounds Contraindications PriMatrix Ag should not be used for patients with a known history of hypersensitivity to collagen or bovine products. This device is not indicated for use in third-degree burns. Warnings and Precautions Do not expose to chemicals or substances other than sterile, room temperature 0.9% saline. Excessive heat can damage collagen. Do not hydrate in 0.9% saline warmed above room temperature. If, when hydrated, the product shrinks in size, DO NOT use the product as it may be damaged. PriMatrix Ag Antimicrobial should be used with caution in regions where an infection exists or is suspected. Treat any existing infection appropriately. Do not resterilize as this may damage PriMatrix Ag Antimicrobial. PriMatrix Ag Antimicrobial is for single patient use only. Do not use product if past the date of expiration indicated on the product label. PriMatrix Ag Antimicrobial is available in meshed, fenestrated, and solid forms. Meshing of meshed and fenestrated PriMatrix Ag Antimicrobial is not recommended. Silver-containing compounds are known to cause a condition known as argyria, a silver-induced darkening of the skin. Frequent or prolonged use of PriMatrix Ag Antimicrobial may result in skin discoloration. 10

Warnings and Precautions, Appearance, Ordering Information PriMatrix Ag Antimicrobial Dermal Repair Scaffold The following complications are possible. If any of these conditions occur, the device should be removed. Infection Chronic inflammation Allergic reaction Excessive redness, pain, swelling, or blistering Appearance This product, like other silver-containing products, may darken upon storage, after hydration in saline, when exposed to light, or when in contact with body fluids and tissues. This darkening does not affect product performance. Reference Description Configuration 607-101-660 6 cm x 6 cm Solid 607-104-660 6 cm x 6 cm Fenestrated 607-105-660 6 cm x 6 cm Meshed 607-101-880 8 cm x 8 cm Solid 607-104-880 8 cm x 8 cm Fenestrated 607-105-880 8 cm x 8 cm Meshed 607-101-812 8 cm x 12 cm Solid 607-104-812 8 cm x 12 cm Fenestrated 607-105-812 8 cm x 12 cm Meshed 607-101-112 10 cm x 12 cm Solid 607-105-112 10 cm x 12 cm Meshed 607-101-125 10 cm x 25 cm Solid 607-104-125 10 cm x 25 cm Fenestrated 607-105-125 10 cm x 25 cm Meshed 607-101-225 20 cm x 25 cm Solid 607-104-225 20 cm x 25 cm Fenestrated 607-105-225 20 cm x 25 cm Meshed 11

Availability of these products might vary from a given country or region to another, as a result of specific local regulatory approval or clearance requirements for sale in such country or region. n Non contractual document. The manufacturer reserves the right, without prior notice, to modify the products in order to improve their quality. n Warning: Applicable laws restrict these products to sale by or on the order of a physician. n Consult product labels and inserts for any indication, contraindications, hazards, warnings, precautions, and instructions for use. For more information or to place an order, please contact: United States, Canada, Asia, Pacific, Latin America USA 844-774-6287 844-329-7746 fax n International +609-936-5400 609-750-4259 fax n integralife.com/contact PriMatrix, Integra and the Integra logo are registered trademarks of Integra LifeSciences Corporation or its subsidiaries in the United States and/or other countries. 2017 Integra LifeSciences Corporation. All rights reserved. Printed in the USA. 0M 0393704-3-EN