title: The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care.
abstract: Treatment of combat injuries and resulting wounds can be difficult to treat due to compromised and evolving tissue necrosis, environmental contaminants, multidrug resistant microbacterial and/or fungal infections, coupled with microvascular damage and/or hypovascularized exposed vital structures. Our group has developed surgical care algorithms with identifiable salvage techniques to achieve stable, definitive wound coverage often with the aid of certain regenerative medicine biologic scaffold materials and advanced wound care to facilitate tissue coverage and healing. This case series reports on the role of urinary bladder matrix scaffolds in the wound care and reconstruction of traumatic and combat wounds. Urinary bladder matrix was found to facilitate definitive soft tissue reconstruction by establishing a neovascularized soft tissue base acceptable for second stage wound and skin coverage options within traumatic and combat-related wounds.
authors.affiliation: Department of Plastic & Reconstructive Surgery, Division of Burn, Wound & Trauma, Wexner Medical Center of the Ohio State University, 915 Olentangy River Road, Ste 2100, Columbus, OH 43212, USA.|Plastic & Reconstructive Surgery Service, Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.|Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Ian L
authors.initials: IL
authors.lastname: Valerio
authors.affiliation: Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Campbell
authors.affiliation: Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sabino
authors.affiliation: DoD-VA Extremity Trauma & Amputation Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.|Department of Physical Medicine & Rehabilitation, Uniformed Service University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Dearth
authors.affiliation: Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.|Department of Orthopedics, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Fleming
mesh_terms: D000328:Adult; D000465:Algorithms; D000671:Amputation, Surgical; D001132:Arm / Q000601:surgery; D005109:Extracellular Matrix / Q000378:metabolism; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D044968:Regenerative Medicine / Q000379:methods; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014481:United States; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery; D014857:Warfare; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery* / Q000628:therapy; D055815:Young Adult
keywords: biologic scaffolds; combat casualty care; extracellular matrix (ECM); extremity trauma; limb salvage; regenerative medicine; soft tissue regenerate; urinary bladder matrix (UBM); vascularized wound bed