Reconstructive, regenerative surgery

ADM for connective and soft tissue repairs

Rematrix is a cell-free, non-pyrogenic collagen matrix (ADM) derived from pig skin.

Rematrix is intended for use as a surgical membrane in connective and soft tissue repairs for tissue support, coverage or use as a tissue substitute. Rematrix is available in different sizes and two different thicknesses 0.8 and 1.5 mm. Rematrix is provided double sterile packed and dry and contains no preservatives.

In the acellular matrix Rematrix, the original structure as well as the high mechanical resilience of the proteins, as they are present in the original pig skin, are preserved. No induced structural changes (cross-linking) are required. In addition, direct integration into the host tissue is possible. Rematrix preserves the structure and strength of the pre-existing microvascular network. This allows the patient’s blood to easily penetrate the matrix, accelerating cell migration and tissue regeneration.

Properties

• resilient, biocompatible implant
• Easy cutting to the defect size in dry or rehydrated state
• grows into the recipient tissue through cellular and microvascular infiltration
• Completely resorbable within 6 months
• Easy handling, good sewing, good fitting
• without chemical cross-linking

Practical application description

Rematrix can be adapted to the desired size and shape of the defect to be treated with scissors in a dry or rehydrated state, while maintaining sterility. The use of appropriate templates may be useful in determining the area required. Rematrix is supplied dry (freeze-dried) and sterile (using ETO) and must be rehydrated prior to implantation by placing the ADM in a sterile tray at room temperature for at least 5 minutes after opening the pack and covering completely with sterile saline, Ringer’s solution or Ringer’s lactate solution. Rematrix becomes glassy when rehydration is complete. When placing the Rematrix membrane, maximise contact with healthy, well vascularised tissue to promote cell ingrowth and new tissue formation. An overlap with healthy tissue of at least 2-3 cm is recommended.

APM for general surgery

Xenoguard is a cell-free, non-pyrogenic collagen matrix derived from porcine pericardium. Xenoguard is intended for use as a surgical membrane in connective and soft tissue repairs and is used for tissue support, coverage or as a tissue substitute. Xenoguard is particularly used when longer implant life in the tissue is required. Xenoguard is available in different sizes. Xenoguard is supplied double sterile packed and dry and contains no preservatives.

Properties

• strong and biocompatible implant
• Simple surface adaptation
• grows into the recipient tissue through cellular and microvascular infiltration
• very thin (approx. 0.15 mm)
• Multi-directional tensile and tear strength
• No sticking after rehydration
• does not swell after rehydration

Practical application description

Xenoguard can be adapted to the desired size and shape of the defect to be treated in a dry or rehydrated state using scissors, while maintaining sterility. The use of appropriate templates can be helpful in determining the area required. Xenoguard membrane is supplied dry and must be rehydrated before implantation by placing it in a sterile dish at room temperature for at least 5 minutes after opening the pack and covering it completely with sterile saline, Ringer’s solution or Ringer’s lactate solution. Xenoguard becomes glassy when rehydration is complete. Xenoguard can be folded and cut to fit the implant site, taking care to overlap, following asepsis instructions. Insert Xenoguard into the implant site using sterile gloves or sterile forceps. Suture the inserted membrane. When inserting the Xenoguard membrane, maximise contact with healthy, well-vascularised tissue to promote cell ingrowth and new tissue formation. An overlap with healthy tissue of at least 2-3 cm is recommended.

Thin ADM (0.6 mm) for breast reconstruction

Rematrix Breast is a collagen matrix derived from pig skin. The ADM is preserved by lyophilisation and is free of preservatives. It is cell-free and non-pyrogenic. Acellular dermal matrix (ADM) is used as an implant to regenerate and strengthen soft tissue. Through cellular and vascular immigration into the structure of the implant, new regenerated soft tissue grows and the implant material is fully incorporated. Already two months after the procedure, histological examinations of tissue samples have shown that the ADM is fully integrated into the recipient tissue. At the same time, the remodelling of the ADM into revascularised recipient tissue occurs in parallel with the complete integration of the xenogenic collagen.

Properties

• strong and biocompatible implant
• only 0.6 mm thick
• grows into the recipient tissue through cellular and microvascular infiltration
• simple handling, well suturable and adaptable
• the collagen matrix is completely transformed into the body’s own collagen tissue within a few months.
• Flexible in the choice of method (subpectoral or prepectoral application) due to the 30*21 cm dimension (REF RM30-06).

Applications

Rematrix Breast is intended for breast reconstruction after mastectomy in a single-stage procedure. Rematrix Breast can be used as a rectangular membrane for the subpectoral implantation technique or after prior cutting by the surgeon for the prepectoral implantation technique. In the subpectoral implantation technique, the ADM acts as a kind of extension of the pectoralis major muscle. Prepectoral breast reconstruction (PPBR) after tumour-induced mastectomy is becoming increasingly common in clinical practice. The most significant advantage is that the pectoral muscle is spared. Compared to the subpectoral technique, this is associated with a significant reduction in pain and time to full recovery and weight-bearing capacity of the arm and shoulder. Another advantage of the prepectoral placement is that possible tension transfers from the pectoral muscle to the implant are avoided. These could lead to unnatural changes in breast shape known as “dancing breast” or “animation deformity”. In the prepectoral technique, the implant is positioned on the pectoralis major by fixing the collagen membrane with interrupted sutures. The function of the muscle is thus preserved.

Practical application description

Rematrix Breast can be adjusted to the desired size and shape with scissors in a dry or rehydrated state while maintaining sterility. If necessary, two products can be sewn together. The use of appropriate templates may be useful in determining the area required. Rematrix Breast Membrane is supplied dry and must be rehydrated before implantation by placing it in a sterile dish at room temperature for at least 5 minutes after opening the pack and covering it completely with sterile saline, Ringer’s solution or Ringer’s lactate solution. Rematrix Breast will become glazed when rehydration is complete. When inserting the Rematrix Breast membrane, maximise contact with healthy, well-vascularised tissue to promote cell ingrowth and new tissue formation. Suture the inserted membrane to the detached pectoral muscle and chest wall (for subpectoral breast reconstruction) or the fascia of the pectoral muscle (for prepectoral breast reconstruction) around the inserted breast implant. Complete the standard surgical protocol, making sure there are no gaps between the membrane and the inserted breast implant and the sutured skin flaps.

Physicians must be familiar with the surgical procedures and techniques for biological surgical matrices and specifically for ADM-assisted implant-based breast reconstruction before using Rematrix Breast. When selecting patients, the following conditions are associated with an increased risk of complications and require individual consideration of the benefit/risk ratio by the surgeon. morbid obesity with an increased BMI > 40 kg/m²; inadequately controlled diabetes mellitus; active smoker; chronic immunosuppression; damage from previous radiotherapy.

Rematrix Ortho – ADM for orthopaedic surgery

Rematrix Orthoist a native, cell-free, non-pyrogenic collagen membrane (acellular dermal matrix, ADM) derived from porcine skin and is intended for use as a surgical membrane to repair, reinforce, cover and rebuild soft tissue for supportive use in the repair of tendon and ligament injuries. Examples include

• Rotator cuff
• Achilles tendon and other tendons of the ankle joint
• Anterior cruciate ligament and other ligaments of the knee joint
• Quadriceps and patellar tendon
• Tendons of the extensor carpi radialis brevis muscle (tennis elbow)
• Biceps tendon

The acellular collagen matrix is a biocompatible implant that grows into the recipient tissue through cellular and microvascular infiltration. While newly regenerated soft tissue is created in this way, the implant material is completely resorbed. The mechanical strength of the tendon and ligament repair sites is ensured solely by the surgical sutures used to repair tendon ruptures and sutures and suture anchors used to attach tendons and ligaments to bone, and not by the insertion of Rematrix Ortho.

Properties

• easy handling, no chemical cross-linking, no preservatives
• Fully resorbable
• By preserving the spatial and biochemical 3D structure of the structural and functional ECM components, Rematrix Ortho offers a suitable scaffold for cellular and vascular infiltration, thereby accelerating the process of tissue defect regeneration.
• The preserved tripelhelical structure of the collagen leads to effective haemostasis, in the course of which wound healing is influenced by mediators such as cytokines (interleukins, growth factors, etc.) in the sense of constructive remodelling.
• The tissue regeneration induced in this way accelerates both the healing of surgical tendon sutures and the reattachment to bone of detached tendons fixed with sutures and suture anchors.
• Increases the likelihood of restoring resilience to damaged tendons and ligaments and reducing functional limitations and pain