Wednesday, April 24, 2013

WC Day 24: Our Guinea “Pig”

Madi Day 2 after surgery

Two weeks ago, Madison had surgery. As I shared here before, she had developed an abscess in her abdomen, around her g-tube (feeding tube) tract, back in September. Three weeks ago it flared again, for the third time, and this time it developed fistulas (small tracts going from the internal abscess to the surface of the skin). That it was reoccurring, and now producing fistula’s meant we were not actually killing off the infection, just calming it down, and our only resort was to do surgery.

The treatment for fistulas is rather barbaric (at least as far as I am concerned). They use a guide wire to locate the path of the fistula, then cut down to the wire……and then leave it open to heal from the inside out. It’s the only foolproof way to ensure the fistula closes, but ugh on open wounds, especially open wounds right by a g-tube site.

My biggest concerns, in no particular order, were 1. Pain….as much pain as the abscess caused, I was understandably concerned that an open incision was going to hurt. 2. Infection…..specifically staph, as the kids are all colonized with it, and it’s something we fight regularly, and it always involves an open wound. And 3. Healing…..because of Madison’s connective tissue issues, healing can be a challenge and always leaves nasty scars and such. I shared these with our surgeon, not totally sure he was taking it all as seriously as I considered it to be.

I was wrong.  He heard me

When the surgeon came to talk to me after the surgery, he shared that with Madison’s special issues in mind, he was trying something new with her. He said it was a product, interestingly enough, made out of pig bladder that was supposed to help healing happen more quickly and he was hopeful it might make a difference for our girl. With that, we were off to our room, where I spent some time trying to figure out what this stuff was. Google “pig bladder wound healing” and there are quite a few articles on it, all of which made it sound pretty stinking promising!! It was originally used on war veterans with wounds that were not healing as they should, and were frequently risking the limbs being salvageable. This “pixie Dust” as one of the soldiers took to calling it, is capable of facilitating the growth of not only skin, but muscle and nerve!! I was kind of excited about the prospect of what this might do for Miss Madison.

The following day I shared with the surgeon that I had read up on this “new” product (it’s actually been around for a little while now) and that I was excited by the prospect. He cautioned that he wasn’t really sure what it was going to be capable of doing, but that he liked the idea of leaving the site alone, and was remaining skeptical on the wound healing part of it till he saw it with his own eyes.

Apparently the company that makes “pixie dust” has been talking to him for some time about trying it, but Madison was the first patient he has had that he thought this might help. As he should have been, he was reserving judgment till he was able to see what it was capable of. With that, I didn’t get my hopes up too high, and we left the hospital with care instructions, and a 6-8 week timeline on healing. We also left with a kid that had essentially no pain at all from the site.

Care instructions really could not have been easier. Twice a day we remove a 3x3 split gauze that’s covered with tagaderm, and then reapply the same. There is no cleaning and no touching of the wound site. There is a thin wound covering that stays in place over the wound and is only removed and replaced when we see the surgeon or his nurse.

At the one week mark, we returned to the surgeon’s office to see how things were going. As soon as our surgeon saw the progress that had already been made, he was clearly impressed and started talking to the rep from the company about some other difficult patients he has. I knew then that it was apparently working better than expected, and was thrilled to hear it!! Looking at the site didn’t do much for me….I did not see it immediately after the surgery, so my ability to compare wasn’t good. But from the doctors response, it was clear a ton of progress had already been made.

What I could see that day made it difficult for me to be able to imagine how this was going to go. The fistula she had went directly into the g-tube tract, so to cut down to it meant we essentially lost one whole side of her g-tube tract. At this first visit, this was still very much the case, so rather than the circle usually there, it looked more like an ice cream cone, with a scoop of ice cream on top. The idea that this was going to somehow heal and leave us with an intact g-tube site was difficult to imagine.

As they did the day of surgery, another application of “pixie dust” was done at this first post surgery visit.

So what is this stuff?? In layman’s terms, it is pig bladder cells (any animal or organ can apparently produce something similar, but pig bladders are apparently cheap, so they are used) that become a matrix that encourages cell growth. It seems to be similar to what we hear is possible with stem cells, and from the reading I have done, it encourages whatever cell growth is needed where it is put. So if it’s muscle, nerves, skin, or all three, these are encouraged to grow where this matrix is introduced. It really is fascinating!!

So today was our second visit to see how things are going.  This time I had something to compare it to, and took a quick look at the picture I had taken last week so I could fully appreciate any progress that had been made. All I can say is WOW!!!!

One short week later she has a clear g-tube tract and there is not even that much healing left to take place going out from the site!!! Things looked so good, we did NOT need to do another application of pixie dust!!

We are TWO weeks out from a surgery that they expected to take 6-8 weeks to heal, and I won’t be shocked if it is almost there by next week. We have had no pain, no infection, and at least at this point, it looks like the healing is going to not only be faster than we could have ever hoped for, but “cleaner” and nicer looking than we could have hoped for!! This stuff really is amazing!!!

And now, our precious daughter will always be known as our guinea pig, or that she has a little piggy in her....LOL

For those that like details:
About MatriStem

MatriStem devices are comprised of naturally-occurring porcine urinary bladder matrix (UBM).  The bladder is harvested and processed to remove the muscle and submucosa tissue layers.  The product is disinfected, packaged, and sterilized via electron beam radiation.  The resulting product is a non-crosslinked, completely resorbable, acellular extracellular matrix scaffold with naturally-occurring collagens, featuring an intact epithelial basement membrane surface and tunica propria surface.


MatriStem contains a collection of proteins arranged in a three-dimensional structure not currently available in synthetic materials.  This ECM scaffold technology is recognized by its bimodal surface characteristics.  The intact basement membrane surface is hypothesized to contribute to epithelial and progenitor cell attachment and proliferation.  The lamina propria surface may be conducive for integration into the wound bed and host connective tissues.


The product completely incorporates into the surrounding tissue during the healing process and leaves new tissue where scar tissue formation is normally expected.  The result is constructively remodeled, site-specific tissue for a variety of medical procedures.

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