Complex wounds treated with MatriStem xenograft material: case series and cost analysis

Introduction Complex wounds remain challenging to treat and heal, and those that involve additional risk factors such as immunosuppression, tobacco abuse, Crohn’s disease, diabetes and obesity pose increased risks of delayed healing, non-healing, reoperation and reinfection. Treatment of wounds is often costly, involving materials, personnel and procedures. MatriStem (Acell Inc., Columbia, MD) is a regenerative extracellular matrix material derived from the porcine bladder that has shown efficacy in facilitating the healing of complex wounds. In this analysis, 10 diverse cases of complex wounds treated with periodic MatriStem application at a single institution are examined, and the materials costs of treatment are calculated. These costs are compared with comparable wound care materials costs at the same institution using what has to date been the conventional wound treatment protocol: negative pressure wound therapy. Case series We present 10 cases of complex wounds treated with MatriStem xenograft material in repeat applications until the wound was maximally healed. In each case presented, the original surgery involved placement of a MatriStem graft, and the costs of this graft are represented based upon hospital contracted pricing. In subsequent weeks, patients were treated with bedside or in-office additional MatriStem material, either in the form of ground powder or in the form of single-layer wound sheets. The costs of these materials are also depicted, based upon the payment schedule from our facility. An analysis of the cost of care is provided and compared with weekly costs of care in the same institution when conventional methods using negative pressure wound therapy is utilised. Results Using weekly MatriStem applications, each patient achieved healing of the wound without infection or complication, and the median treatment time was 11 weeks. The average cost of materials per week for healing these wounds using MatriStem is $152 per week. The costs of materials for negative pressure wound therapy calculated from the same contracted pricing agreements by the same institution are $501 per week. MatriStem wound treatment is less costly for this diverse set of 10 wounds on a weekly basis than treatment with negative pressure wound therapy. This holds true even when the cost of the initial graft is included in the analysis. Further discussion illuminates why labour, transportation and miscellaneous supply costs are also lower for MatriStem treatment when compared with negative pressure wound therapy Discussion Treating complex wounds is a challenging and costly process. The use of MatriStem (Acell Corporation) has proven effective in achieving and accelerating wound healing in other studies. In this study, treatment of a diverse array of complex wounds resulted in successful clinical healing of the wounds without complications, re-infection or reoperation. Conclusion Patients undergoing wound care with MatriStem report satisfaction with reduced need for visits, eliminating the need for wearing or carrying a negative pressure wound therapy device, elimination of the need for dressing changes and reduced interactions with both the medical personnel and the wound itself. The costs of materials for the treatment of these wounds are substantially less on a per-week basis than the costs at the same institution when negative pressure wound therapy is utilised.