Tissue Reconstruction and Remodeling Using Acellular Bladder Matrix

Abstract

Objectives: Attendees should be able to (1) learn of an innovative new material for full thickness repair utilizing urinary bladder matrix (UBM); (2) understand the basic mechanism of this procedure; (3) apply this technique and material to daily surgical use. Methods: Over the past 3 years MatriStem (ACell, Inc.) has been used successfully by the author in multiple head and neck reconstructive procedures, including repair of major, full thickness cancer and osteoradionecrosis cases of the scalp, face, and nose, full thickness oral and mandibular bone defects. MatriStem is derived from porcine UBM. Published studies have shown that UBM may recruit progenitor cells to the injury site and stimulate a constructive remodeling response with site-specific tissue. Clinically, MatriStem has shown cost benefits and better patient outcomes compared to other therapies. Previous surgical techniques employed by the author have used various synthetic materials and tissue-derived materials—ranging from cadaveric dermis to bovine tendon—as well as split- and full-thickness autologous skin grafts. However, these techniques did not result in regeneration of full-thickness tissue. These historical results will provide context for the cases to be presented. In this presentation, the author will display many of these clinical experiences. Results: It has even been possible to regenerate partial bone replacement in radiated bone following partial thickness resection. It has been especially useful in repair of head and neck cancer resection defects. Conclusions: The use of MatriStem has offered unprecedented solutions to many challenging and complex cases.