{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:54:15Z","timestamp":1788742455504,"version":"build-2803163510"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>Urinary bladder matrix (UBM) grafting of acute or infected wound defects has been reported to be successful in small case series. The purpose of this study was to compare the outcomes of UBM grafting with flap coverage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>This is a retrospective comparative study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level-1 trauma center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Orthopaedic trauma patients with wound defects not amenable to primary closure or skin grafting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Wound coverage with UBM grafting (n = 26) by orthopaedic trauma surgeons versus flap coverage (n = 26) by microvascular-trained plastic surgeons.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Primary wound coverage success, complications, returns to the operating room, hospital length of stay, and time to wound healing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The UBM group was more likely to have an American Society of Anesthesiologist class \u22653 (58% vs. 23%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02), a foot\/ankle wound (77% vs. 12%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), an infected wound defect (81% vs. 50%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03), and smaller defects (21 vs. 100 cm<jats:sup>2<\/jats:sup>, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02). UBM grafting resulted in a longer time to wound healing (6 vs. 2 months, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002) and a shorter hospital length of stay (2 vs. 14 days, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). UBM and flap groups had similarly high rates of failure of primary wound coverage (31% vs. 31%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 1.0), complications (46% vs. 62%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.4), and returns to the operating room (46% vs. 65%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.2). All 3 acute traumatic wounds undergoing UBM grafting concurrently with fracture fixation experienced graft failure and osteomyelitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>UBM grafting is an effective alternative to flap coverage for small traumatic or infected wounds but should be avoided in acute traumatic wounds undergoing fracture fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002406","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T21:02:47Z","timestamp":1652821367000},"page":"e374-e379","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Urinary Bladder Matrix Grafting Versus Flap Coverage for Acute or Infected Wound Defects in Patients With Orthopaedic Trauma"],"prefix":"10.1097","volume":"36","author":[{"given":"Leela S.","family":"Mundra","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, University of Colorado School of Medicine, Denver, CO; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8262-4065","authenticated-orcid":false,"given":"Joshua A.","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"608E","DOI":"10.1097\/PRS.0000000000006589","article-title":"Comparative effectiveness analysis of complex lower extremity reconstruction: outcomes and costs for biologically based, local tissue rearrangement, and free flap reconstruction","volume":"145","author":"Kozak","year":"2020","journal-title":"Plast Reconstr Surg"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/PRS.0b013e3182173d3a","article-title":"Foot and ankle reconstruction: pedicled muscle flaps versus free flaps and the role of diabetes","volume":"128","author":"Ducic","year":"2011","journal-title":"Plast Reconstr Surg"},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/PRS.0000000000003927","article-title":"Muscle versus fasciocutaneous free flaps in lower extremity traumatic reconstruction: a multicenter outcomes analysis","volume":"141","author":"Cho","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"e152","DOI":"10.1097\/BOT.0000000000002245","article-title":"Urinary bladder matrix grafting: a simple and effective alternative to flap coverage for wounds in high-risk orthopaedic trauma patients","volume":"36","author":"Parry","year":"2022","journal-title":"J Orthop Trauma"},{"key":"R5-20250614","first-page":"306","article-title":"Management of open distal lower extremity wounds with exposed tendons using porcine urinary bladder matrix","volume":"28","author":"Geiger","year":"2016","journal-title":"Wounds"},{"key":"R6-20250614","first-page":"3134820973730","article-title":"Extending limb salvage after fourth and fifth transmetatarsal amputation in diabetic foot infections using ACell \u00ae urinary bladder matrix","author":"Underwood","year":"2020","journal-title":"Am Surg"},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1089\/wound.2015.0681","article-title":"New innovations for deep partial-thickness burn treatment with ACell matristem matrix","volume":"5","author":"Kim","year":"2016","journal-title":"Adv Wound Care (New Rochelle)"},{"key":"R8-20250614","first-page":"387","article-title":"Management of open lower extremity wounds with concomitant fracture using a porcine urinary bladder matrix. 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