Utilization of a Novel Porcine Extracellular Matrix as a Dermal Template for Skin Graft

Achieving a vascularized granulation bed is essential prior to split-thickness skin grafting (STSG) but is often protracted with existing dermal substitutes. Porcine-derived extracellular matrix (pECM) powder (XCelliStem Wound Powder; StemSys) supplies structural proteins and growth factors that may shorten this interval.

Three adults with complex wounds-a traumatic dorsal-foot defect, a cervical burn contracture reconstructed with a latissimus flap, and a free omental flap to an upper-extremity degloving injury-received intraoperative application of hydrated pECM powder following meticulous debridement. Wounds were covered with Xeroform and either hypochlorous-soaked gauze or negative pressure wound therapy. Granulation, exudate, and infection were assessed daily; STSG was performed once a uniform, vascular bed formed. Patients were followed for ≥3months.

Complete, healthy granulation tissue developed on post-application days 9, 11, and 13, respectively, enabling timely STSG. All grafts achieved 100% take without necrosis, seroma, or infection. At 3 months, each site displayed durable coverage, preserved function, pliable scars with preserved elasticity, and high patient satisfaction.

In this preliminary series, pECM powder accelerated wound bed readiness and supported reliable STSG within 2 weeks-substantially faster than the 3- to 7-week intervals reported for Integra Bilayer Matrix (Integra LifeSciences Corp) and NovoSorb Biodegradable Temporizing Matrix (PolyNovo Ltd). The pECM powder appears safe, easy to apply, and may reduce morbidity and resource use; controlled trials are warranted.