BACKGROUND. Sinus tracts are difficult wounds where clinical evidence to direct management is lacking. Should medical therapy fail, surgical options focus on various flaps and tissue grafts. We report the successful use of a simple surgical procedure to promote healing in recalcitrant sinus tracts: the use of the dermal matrix substitute Cymetra (LifeCell Corp., The Woodlands, NJ). OBSERVATIONS. Two patients - one a woman with a chronic sacral decubitus and the other an older gentleman with pyoderma gangrenosum - each developed a sinus tract that was unresponsive to medical therapy. After use of Cymetra, both patients healed completely without adverse reaction. They remained ulcer free at 1-year follow-up. CONCLUSION. Cymetra, micronized decellularized cadaveric dermis, may have utility in repairing soft tissue defects and promoting wound healing. It offers a safe and effective alternative in the management of recalcitrant sinus tracts.
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