Surgical Management of Stage 3 and 4 Pressure Injuries in Trauma Patients Using Ovine Forestomach Matrix Grafts: A Prospective Case Series
Summary: This prospective observational case series at a level 1 trauma center evaluated ovine forestomach matrix (OFM) grafts (sheet or granular) as an adjunct in 9 trauma patients with 12 stage 3/4 pressure injuries (75% stage 4, mean area 46 cm², many with tunneling/undermining or osteomyelitis). Following surgical debridement, OFM was applied and covered with non-adherent dressings ± negative pressure wound therapy. Median applications: 1.0. Outcomes included median time to 50% granulation of 2 weeks and complete granulation coverage of 6.5 weeks. Tunneling/undermining resolved in 50% and improved in the rest. Mean percent area reduction at ~23-week follow-up was 61%. No postoperative complications (infection, graft loss, hematoma) occurred. OFM provided immediate coverage, promoted neovascularization, simplified care, and may facilitate later reconstruction or secondary intention healing.
Key Highlights:
- Rapid granulation: median complete coverage 6.5 weeks with typically single application
- Mean 61% area reduction; tunneling/undermining resolved or improved in most
- No complications in complex trauma/spinal cord injury patients
- Authors: Sophia M. Trinh, Kaitlyn Andre, Alison A. Smith et al.
Read full open-access case series
Keywords: ovine forestomach matrix, stage 4 pressure injury, pressure ulcer surgery, Alison A. Smith