Clinical Case Highlights Urinary Bladder Matrix Efficacy in Infected Calcaneal Wound Healing
A surgical site infection developed in a 43-year-old male patient within three weeks of undergoing open reduction and internal fixation for a comminuted calcaneal fracture, Cureus reported. The case details the successful management of the contaminated wound utilizing a combination of surgical debridement and urinary bladder matrix products, achieving complete epithelialization and tissue remodeling within 55 days of initiating the regenerative therapy.
Surgical Intervention and Debridement Following Fracture Repair
The patient initially sustained a displaced, comminuted intra-articular calcaneal fracture in February after falling approximately four meters while working. Computed tomography in March 2025 confirmed multiple bone fragments, leading to open reduction and internal fixation under general anesthesia. Following discharge in April 2025 with instructions to remain non-weight-bearing, the patient returned in May 2025 displaying clinical signs of a surgical site infection, including wound discoloration, purulent discharge, and a foul odor.
Emergency readmission in May 2025 prompted immediate surgical debridement and copious irrigation using 10 liters of normal saline containing gentamicin to reduce the bacterial burden. Deep tissue cultures identified Enterobacter cloacae as the underlying pathogen.
Application of Extracellular Matrix Materials and Granulation
Following complete removal of devitalized tissue, medical staff applied 300 mg of MicroMatrix® urinary bladder matrix powder directly to the wound bed. A 7 × 10 cm Cytal® extracellular matrix sheet was then trimmed and positioned inside the wound to act as a structural scaffold for cellular infiltration and tissue repair. Urinary bladder matrix devices serve as extracellular matrix scaffolds that modulate inflammation and promote tissue remodeling, potentially exhibiting antimicrobial activity via bioactive peptides generated through collagen and elastin proteolysis.
Robust granulation tissue formed within two days of the extracellular matrix application, demonstrating early progression of wound healing. Subsequent outpatient monitoring revealed wound maceration caused by poor adherence to postoperative care instructions. Clinicians subsequently initiated hyperbaric oxygen therapy, applied an additional 200 mg of MicroMatrix® powder, and utilized a silver hydrofiber dressing to manage moisture levels.
Postoperative Recovery and Complete Wound Closure
Continuous telephone follow-up between clinic visits helped reinforce home wound care instructions and improved patient compliance. Satisfactory healing progression allowed clinicians to discontinue urinary bladder matrix applications and transition to routine dressing changes with non-adherent gauze while maintaining a posterior backslab.
Complete wound closure and tissue remodeling were achieved within 55 days of starting the regenerative matrix therapy, allowing for successful suture removal. Follow-up examinations confirmed no recurrent infection, wound dehiscence, or requirement for further surgical procedures.
Frequently Asked Questions
What specific organism was cultured from the infected surgical site?
Deep tissue specimens obtained during the emergency debridement yielded Enterobacter cloacae upon culture and antimicrobial susceptibility testing.
What exact regenerative products were applied to the wound bed?
Clinicians applied 300 mg of MicroMatrix® urinary bladder matrix powder along with a trimmed 7 × 10 cm Cytal® extracellular matrix sheet.
How long did it take for the wound to achieve complete healing?
Complete wound healing and successful suture removal were accomplished within 55 days of initiating the urinary bladder matrix therapy.
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