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PSIS
PSIS
PSIS is a three-dimensional acellular matrix derived from porcine small intestinal submucosa. It is a skin substitute that acts as a scaffold to promote cellular migration, wound bed granulation, and revascularization.88,95 It may be stored at room temperature for up to 2 years.96 A randomized, controlled trial evaluating the effectiveness of PSIS with compression therapy versus standard wound care (compression therapy alone) in the treatment of chronic VLUs found that a greater proportion of wounds were healed by 12 weeks in the PSIS group (55% of the PSIS group compared to 34% of the standard wound care group).88
Indications PSIS is indicated in the treatment of partial- and full-thickness acute and chronic wounds including VLUs, DFUs, pressure ulcers, peripheral vascular ulcers, burns, trauma wounds, draining wounds, and surgical wounds.95,96
Contraindications PSIS is contraindicated in patients with a sensitivity to porcine material. It is not indicated in the treatment of third-degree burns.96 Before application, excessive swelling, bleeding, infection, and exudate should be addressed.95,96
Procedural technique Prior to application, the wound bed should be prepared appropriately. Necrotic debris and devitalized tissue should be debrided. After measuring the wound the sheet of PSIS is cut to a size that will fully cover the wound bed and extend just past the wound margins using sterile technique. For exudative wounds, a scalpel may be used to fenestrate the PSIS in order to allow for passage of exudate. Place the sheet of PSIS in the wound bed so that it directly contacts the wound and overlaps the wound margin. Secure it in place using either adhesive tape, sutures, or staples. Rehydrate the matrix with sterile saline. In order to prevent the matrix from adhering to the secondary dressing, first apply a nonadherent primary dressing directly over the sheet of PSIS followed by a secondary dressing. The primary dressing can be changed every 7 days and the secondary dressing can be changed as often as necessary.96