SAMatrix™ with PainGuard® Technology: Designed to Advance Pediatric Burn Recovery

Brad Wiggins (00:02):
You're listening to The Zero Zone, presented by Imbed Biosciences. I'm Brad Wiggins, longtime burn unit nurse, now clinical educator. On this podcast, I talk with surgeons, trauma specialists, wound care teams working towards zero complications in burn and wounds. Just a heads up, if you're listening to us on an audio only platform, there are a handful of images in today's episode, which you can see if you're listening on Spotify or YouTube. These links are in the show notes if you want to hop over to see the video. Welcome back to the Zero Zone. I'm Brad Wiggins and today we're talking pediatric burn and wound care with someone who's built her whole career around it. Dr. Katrina Weaver is a pediatric surgeon at Logan Health in Kalispell, Montana. She came up through surgical critical care fellowship before pediatric surgery, and that combination is why kids with burns and trauma became her focus and joy in her professional practice. Katrina, thanks for being here.

Dr. Weaver (01:00):
You're welcome. It's good to be here.

Brad Wiggins (01:02):
Why don't you tell us a little bit about your clinical role at health and if you will just start with any disclosures that you have so that the audience understands what that looks like.

Dr. Weaver (01:10):
I am a medical consultant for both Imbed Biosciences as well as for Avita Medical. As far as my role, I'm currently here at Logan Health Children's Hospital here in Kalispell, Montana. I've been here for the last three years and I came up here from the University of South Alabama. There, I did my general surgery residency where I had a huge exposure to both burns and wound care and then went on to do fellowships in Kansas City at Children's Mercy for both pediatric surgery and critical care. I then went back to Mobile, Alabama and practiced there and was the director of pediatric burns in addition to working there on their trauma team in the adult burn wound care before I went to do pediatric surgery fellowship. So I have a big exposure to it. I never thought that I would like it as much as I do, but now that I've been really able to focus it in on my pediatric patients, since I've moved here to Montana, that's really what I've tried to build.

(02:14):
As many of the people who know here in Montana, we do not have a burn center, nor do we have any type of a burn centers in any of the Dakotas or Wyomings. And so many of our patients get sent out of state, which can be really, really hard and difficult on these families. And so since I've been here, the goal has been trying to do more pediatric burns and keeping them in the state as well as the adult burns.

Brad Wiggins (02:39):
Where did you go to medical school?

Dr. Weaver (02:41):
I went to medical school at University of Utah in Salt Lake City.

Brad Wiggins (02:45):
Go Utes.

Dr. Weaver (02:45):
That's where I'm born and raised.

Brad Wiggins (02:48):
That's good. And certainly that's close to my heart and my medical career. And obviously I think we crossed paths inside the burn center there.

Dr. Weaver (02:54):
We did.

Brad Wiggins (02:54):
So really excited to be able to have that and know that we have that background together. So I'd love to dive in a little bit more to care delivery for you. So I appreciate you sharing kind of your journey and all the different places you've touched base, but for you personally, wound care, burn care, trauma care does not always appeal to all providers that are going through residency. What for you sparked that interest?

Dr. Weaver (03:20):
A lot of it was how you could make a change and a big difference and you could see it in front of your eyes. And so with the surgeon mentality, that's your fixer. And so you like to see that, but also with wounds, there's many different ways to do a burn or a graft or take care of a wound. And so knowing those little idiosyncrasies as far as what's going to work when and how and what you need to do with the wound really is an art. And so I actually learned because I was taught by some very old school burn surgeons and they had this amazing wound care team and I would go there as a surgery resident when I'd be taking care of other wounds and be like, "What would you do for this? This is what I got. How would you take care of this?

(04:07):
What's out there?" And that's honestly why I like going to the wound conferences and burn conferences now because you're starting to learn all these different techniques on different ways that we can treat the same old burns, but get them to heal faster.

Brad Wiggins (04:21):
How do you feel like the wound care landscape has changed during your career? It's obviously a journey over many years to go from medical school through all the fellowships and the residencies and then establishing the critical care fellowships that you did. Where's the landscape currently?

Dr. Weaver (04:38):
Initially, especially in pediatric burns, they would wait a lot longer before they would go to grafting. And now with some of the product that has come out and actually the scar results and the pigmentation results, we're starting to go to grafting a lot earlier. There's also a big component now that's discussed as far as the PTSD and the anxiety that's associated with the dressing changes and the pain factor and how this is really starting to become a component with our wound care in our pediatric patients and how we can try to lessen that with some of the dressings that we use. And even if we can extend out how often we're having to do the dressing changes, because it's not uncommon for me to be treating both the patient, the pediatric patient, as well as the parent who has the guilt for whatever happened. And you're treating both of those psyches along the way.

(05:34):
And there is a real impact that comes along with it that doesn't even, even after the wound is healed, because of what they had to go through is a big impact that we still deal with.

Brad Wiggins (05:45):
I'd like to change a little bit our topic now. Let's talk on the issue that affects every wound care clinician, infection prevention. Why do wound care infections remain such a significant challenge for you as a clinician and for the patient ultimately?

Dr. Weaver (05:58):
Yeah, because not only is it a huge expense on the healthcare system, it's a huge expense on that child's life and the parent's life because not only are you having to take a child out of school, but you're also taking that parent out of work. And especially here in Montana, they have many other children. And so a lot of times if we have to transfer them out of state or whatnot for an infection that we can't treat here or that we can't easily take care of here, then that's a huge time that they're away from their family. It's just a hindrance on their lifestyle. And so the infection just contributes to that both in the pain and in the duration.

Brad Wiggins (06:36):
I think that understanding that component for patients is something that's a struggle, right? Nobody expects to be burned. Nobody expects to have that wound. They don't know how to incorporate what those things look like and they certainly don't understand the comprehensive time that it takes to actually get closure of these complicated wounds for sure. What's one of the most exciting developments of wound care in the advancements of antimicrobial technologies that you've seen recently?

Dr. Weaver (07:05):
Honestly, with the application of some of these, especially with our SAM technology that we're talking about today and being able to stick both something that is antimicrobial protecting and can also provide a component of pain relief has been one of the biggest things that has helped me and my pediatric population because kids are definitely more resistant than some of our elderly patient population as far as resisting infection, but they're also very dirty. And so even though you may tell a pediatric patient and their family like, "Hey, you need to keep this dressing clean and dry for the next week until we can change it again," that child is still going out fishing and they're still going to school. And so the rate of them getting infected always scares you as a wound care provider because you know that they're going to test your wound care capabilities of your dressings and things like that to the max.

(08:00):
And so if you don't prepare for that, because a lot of the times we try not to keep these kids in the hospital, whereas normally in a burn center, that child may be there for many months on end doing daily dressing changes. We try to really get them out and get them back to life so it helps with their psychological status. And so you have to take both considerations into hand. And so that technology has really helped me in the sense of what I'm trusting them to do and what I trust my wounds to do and not worry so much to the point where many of my patients will travel hours away because we cover all of Montana. And so to be able to know that I can trust that that wound is going to be covered for a certain period of time from an infection standpoint, but also easily enough to apply that they might be able to do so at home.

Brad Wiggins (08:51):
So you mentioned already the SAM technology and that's our synthetic antimicrobial product that we call Pelashield® and it comes with or without lidocaine. And when we refer to it in that, it's called PainGuard®. So primarily you've actually gotten to use both of those. Is there something specific about the characteristics of our antimicrobial dressing that stood out to you that you enjoyed and liked when using it on patients?

Dr. Weaver (09:13):
Yes. So my favorite thing about it is how it adheres to the wound bed. So it just conforms and dissolves into the wound bed in front of your eyes and it allows you to put anything on top of it that you want to. It's a favorite of mine when I have a very contoured wound because I know it's not just going to sit on top and that it's actually going to go into the wound bed crevices and actually do its job there in it. It's very much like Seprafilm or like a Listerine strip because it just dissolves into the wound bed. And it's nice because it doesn't really leave any type of an exodus later that you have to take off, which is really important in pediatric patients because the removal of some of these products can be very painful. And so that is a nice thing about this product.

Brad Wiggins (10:01):
The micro contouring is the part that initially stood out to me the first time that I got to see it. We just over our wound care histories, I have personally never seen a product that actually did that micro contouring. And I think it's fascinating to watch when you go to place it actually on the product. For those of you that are joining us on YouTube, you'll be able to see these slides and do those. If you're joining us on one of just the listening podcasts, we encourage you to look for those YouTube links as well so that you can see the full slides that are available throughout this presentation. We'll reference a few things and this particular video actually shows the incorporation into a piece of granulation tissue on a patient and this is not sped up. The actual video you're seeing actually is the real time placement of this product.

(10:42):
So it really makes a really amazing wound bed covering that seems to be working very well for so many different providers and ultimately patients. So let's talk a little bit about some of the cases that you've used this on. Can you give us an example of maybe a partial thickness injury patient that you've used this on?

Dr. Weaver (11:01):
Yeah. So I've had a couple both in the adult world and the teenage world. One was a teenage girl who spilled some hot boiling water onto her foot while she was cooking and presented because she was in so much pain with some sloughing skin, had some partial mixed thickness burn to the foot, the top of her foot. And her biggest complaint was the pain of the burn. And so I was able to place some of the pain guard after debridement of the wound onto that partial thickness burn and then place a skin substitute over that and did not end up having to graft her. And she reported to me because of that, she was able to attend a sweet 16 birthday party that same day that she was afraid she was going to miss and that the pain in her foot had completely resolved. She did not require any narcotics.

(11:55):
We were just using Tylenol and Motrin on her. That was kind of my first experience with this and that's where I was like, "Wow, this is actually very helpful." My next experience, because I though maybe it's just because she's an emotional teen, but then my next experience was with a Marine who had a flame burn to his arm that was sent to me from the ER the next day. And he reported that the pain was so bad it was like nothing that he had ever experienced before in all of his injuries being in the Marines. And so after debriding him in clinic, I went ahead and used this pain guard on his burn and he reported that next day or that same day he was able to go throw a baseball with his son and that the relief of the pain was instant. I had never been known to bring a Marine down to his knees and crying, but at that burn debridement, he was at that point.

(12:51):
And so it was nice to see that it is effective in all different communities and all different ages because burns are very, very painful.

Brad Wiggins (13:01):
For the audience also that is unfamiliar with the PainGuard® technology, we have taken our antimicrobial polyvinyl alcohol and it has the low dose metalinonic silver in it and we've added lidocaine product to that. Now the lidocaine is equivalent to that, a 4% topical lidocaine, which is from a fairly low dose, which matches the low dose of our silver really quite well. So you're getting the antimicrobial benefits that you need for an open wound, which are really nice, but then you're getting the benefits of the lidocaine. Now, when we first initially looked at this product, I would say to you that we knew we were going to get about 80% release of that lidocaine within the first 30 minutes. And as a longtime clinician, I felt like that would have been great. I'll probably get two to four hours maybe of good pain coverage and reduction in that side.

(13:51):
What are your patients reporting to you about length of time of how much that's lasting?

Dr. Weaver (13:55):
They'll report anywhere between at least a full 24 hours to multiple days. When I've used it in my partial thickness burns right on the spot, it's been at least 24 hours or longer, but it really gets them over that hump as far as the pain receptors initially right after the debridement, which is kind of why we will delay our dressings and try to put them in a dressing that they can stay in for a week so we don't have to re-expose that wound bed right over again to those sensitive nerves. And this is really helping that, especially to the point where I'm not even prescribing narcotics anymore. The other thing I've noticed in when I've used it on donor sites for grafts, I no longer am injecting any type of Exparel or a quarter percent marking into the wound bed or putting anything into my colysis.

(14:46):
And I'm just putting a PainGuard® sheet down and it is lasting for days to the point where they're no longer complaining about their donor site like they used to.

Brad Wiggins (14:57):
You just dumped a whole lot of different clinical cases and clinical fun things and I love that. That's the energy that I'm feeling and seeing from this new exciting product that's on the market. I think that it's something that other burn clinicians and other pediatric clinicians need to have a full understanding. When you look at the antimicrobial properties alone, what success have you had with that? Because I know you've used the Pelashield® without the PainGuard® as well. What kind of cases did you have for that and what were those outcomes like?

Dr. Weaver (15:27):
Yeah. So some of the Pelashield® I've used on have been wounds that have come in that have been inherited. So one specifically was a child who had a degloving injury to his bicep after getting it caught on a boat grommet. And one of the physicians here just reapproximated it hoping that the skin flap would take and that there might be some areas of ischemia. And so there at the approximation mark, there was definitely some ischemic areas there of the skin flap. And so this family was from a couple hours away. They were not wanting to try to go through another excision and debridement of this ischemic area and they were asking for what other options. And so I was like, let's try this. And so what I'd have them do is they would come to clinic typically about every two weeks. And in the meantime, I would have them go ahead and put a piece of this Pelshield® about every three days with just a dry dressing over it.

(16:32):
And they would send me pictures and you would actually see the debriding of the wound in those areas of ischemia to down to the point where I was at fresh, healed skin. I never had to go back and excise him or graft him and he healed. And I want to say that it was due to this product because it was the only thing I used. We didn't have to go on a prolonged course of antibiotics. He never got infected and this is in a dirty lake. And so the risks of infections are really high and then it never turned into that soupy type of wound where you're just worried about how it's going to scar and look. And so it was a great first experience of using Pelashield® and what you could use it for.

Brad Wiggins (17:16):
That's great. The audience that's watching on YouTube is getting all these slides right now and you can see the transitions and the perspective of the healing taking place. And we're so grateful to be able to have that case as sharing off really how the material works. So a couple of times we've talked just about it being a dressing, but is it really a dressing? What is special about this product that's different? Because you don't change it, right?

Dr. Weaver (17:39):
Right. I kind of feel like it's a dressing plus, right? It's easy application as far as a dressing, but it provides so much more. And the way it just dissolves into the wound bed, it makes it very, very easy for patients to just apply and be done. And then there's nothing that they have to take off afterwards when they come back to maybe do another dressing change. They just clean the bed and then they put another application on. And so it makes it very, very easy for them and there's no pain associated with it.

Brad Wiggins (18:13):
That's great. I think that that's a really true benefit of the product is how it simply gets activated by the patient's wound bed. And I think one of the other parts I love to highlight for the antimicrobial technology is you're getting them a minimum of 72 hours of silver kill. And we demonstrate that. We're going to throw another slide up for the audience as well so that you get to see how it actually impacts against lots of different bacteria that's out there and ultimately how it helps to manage these patients' wounds and assist you in getting good closure. I mean, anytime you don't have to do more surgical intervention, although I know you're a surgeon, it's still a nice thing to be able to do that, right? All surgeons want to cut, right? But still in general, I think that the technology here is a unique one and one that offers a lot of different types of opportunities for sure. How important is infection control to you?

Dr. Weaver (19:02):
Oh, very important. From just getting the wound to heal, to kids that we're dealing with in our NICU when we're doing ostomy take downs and we worry about the infections there after we take down their stoma, to our immunosuppressed kids that have cancer related wounds that we're dealing with, and they're the ones who end up with all the weird fungal and yeast infections. And so it's very important, especially if you can provide something at the wound front or even the surgical wound right from the beginning.

Brad Wiggins (19:33):
You care for a very large different patient population. It's just not focused, as you said, on a burn center. This is surgical trauma wound management for you, and you're kind of an A to Z provider. What other type of unique situation and patient cases have you shared this on and had good success with?

Dr. Weaver (19:52):
Yeah. So I have started in some of our, both from the surgical standpoint, like I previously said in some of our NICU cases. So it's very common for a NICU infant to have a perforation. So they're both premature and underweight and we give them ostomies. And then once they're to the point that they're big enough and doing well enough before they go home, we'll try to reverse those ostomies. And they always are at a higher risk of getting a wound infection in those tissues because of the now bacteria that has started to grow there from the stomas. And so a lot of times we would stick in penrose drains or vessel loops and keep the wound kind of open or pack the wound. And then these kids would have these gnarly looking scars across their whole abdomen. And so I've started using both a Pelashield® sheet just down into the wound bed before I close it, which I've seen great results.

(20:51):
I haven't had any infections from those, which has been nice to using it on failed skin grafts where they have granulation tissue and I'm trying to get the wound cleaned up and get it to close without having to do another graft. And so there's been a huge market of where I can use this at as long as I remember like, "Hey, I have this tool in my box and all I need to do is just bust it out and use it."

Brad Wiggins (21:19):
I keep telling people recently that this product has enormous diversity to it. So we have obviously clinicians in the chronic wound space that use our Microlyte product. We have surgical focused providers that might put it in an incision for a back incision, as an example. We have cancer physicians that are using it during cancer resection and abdominal wounds and on closure. We have orthopedic space clinicians that are using it in orthopedic with knees and hips. And then we're talking about burn management, and then you throw in the pain guard and we have excitement over the fact that you're getting pain reduction with such great outcomes. So let's flip back over to a benefit of a patient that you've seen maybe with both needing the antimicrobial protection and that of the pain guard. Could you highlight maybe another case for us?

Dr. Weaver (22:08):
So I've had some very deep burns, some third degree, fourth degree burns from exhaust pipes and things like that that have become delayed. And so you worry because at that point the wound is already not great. It doesn't appear great. And so by the time you excise it, to take the chance of opening up another wound for a graft to go over that, you really want to make sure you have a clean wound bed. And so I've used it in those situations after I've excised it, put it down, maybe even put a dermal sub over it with a wound vac, and then brought it back to the point where it's ready to graft in five days or whatnot. Never had to deal with any type of an infection. And these are always in areas that are not great to keep clean. And so it helps it in those sense because it gives you a good bed to go ahead and open up a new wound to put something down on.

(23:03):
And what's nice is that it's something that I can reapply and not have to worry about the toxicity of whatever it is I'm reapplying on it. Because especially with the lidocaine, once we start getting into kids of smaller weights, we really have to be careful about how much lidocaine we're using when. And a lot of those kids, we can't even use Exparel because it's not FDA approved in those. And so it really limits us as far as what we can use for their pain control. And so with these lidocaine in the pain guard, it has been a night and day difference for these because of the coverage that we can get where we need it.

Brad Wiggins (23:42):
Why are less narcotic use important, less use of opioids? Why is that such an important thing to you as a provider and why is that ultimately best to reduce that for patients?

Dr. Weaver (23:52):
Most of it is because of one, the substance abuse that we see. We see that a lot in our teens. Here in Montana especially, they have a huge narcotic issue, whether it be fentanyl or whatnot. And so they're really strapping down as far as the narcotics, but it's also because a child doesn't function very well when they have to have a narcotic. Not only does it cause systemic effects like constipation and things like that, but they really can't be functional in school or anything. And so knowing just a child, it really puts them out for being able to go back to their daily living and things like that, let alone them becoming a dependency on it. And so that's why we really try to fight. But I also like the other factor is that in my clinic, I don't have the capabilities of having nitrous oxide or anything like that with a dressing change.

(24:45):
And so if I can use this dressing right off the bat and show the child that it's not going to hurt and that it actually provides relief, it makes every single dressing change after that so much better because the anxiety factor that comes along with that has just diminished. And so it's a twofold, whereas I used to pre-medicate all my dressing changes with both a Valium or an Ativan and an oxycodone, and now I don't at all.

Brad Wiggins (25:14):
Doesn't that just speak volumes right there? Because I think if I was to say to you as a longtime wound manager of pediatric patients, you hit the nail on the head, anxiety for a pediatric patient, the anxiety that's created by parents in the room, the anxiety that the child feels by the medical staff of not understanding and be able to rate to that. And then for you to have a choice of option that's calming all of those things without the need for narcotics, that's a game changer and it's pretty unheard of within our population.

Dr. Weaver (25:45):
It definitely has been.

Brad Wiggins (25:46):
Yeah. The name of this podcast is The Zero Zone. We're very focused on a very bold goal, the idea of zero infections. Do you think that's possible? Is it a realistic target for us to think about? And how does that ultimately apply to you and your clinical role?

Dr. Weaver (26:02):
I think it's a great goal. I'm an optimistic, so I would say yes. I think we've all, especially in general surgery and wound management, we've all learned specific techniques to try to help us decrease wounds. I think that they'll always be out there, but I think that we can improve those in both our surgical practice, but I don't necessarily feel like it comes to the point of having to have everybody on an IV antibiotic. I feel like we also see some of the downside to that with our resistance. And so when you have something like this with the silver component of it, and that's what is fighting our infections, I think that we're going to see if we start using that more, we're going to see a lot less resistance to these IV antibiotics that we're throwing at all these wounds and things like that, that it doesn't need it.

(26:52):
It needs something topical. I think we're getting there. It just takes a lot of force.

Brad Wiggins (27:00):
Absolutely. And a lot of teamwork and a lot of holistic vision. I keep coming back to that, but it ultimately was my favorite and it continues to be my favorite focus for all healthcare delivery is a holistic approach to that so that you get the best possible outcomes. What lessons can other facilities, other providers, and even maybe other patients that they're listening to this, learn from your experiences so far? What would you have to offer to those areas?

Dr. Weaver (27:25):
I would say that the scope of the practice is so broad. A lot of people will say like, "Oh, I only do plastics or I don't get infected wounds or whatever the case may be." And I think that it shows you that you can use it as both a preventive measure, you can use it as a salvage measure to clean up a wound, and you can also use it as pain control with something on the side to help you prevent that infection. And so there's so many different avenues that you can use this product on. And since it is so easy to apply, it doesn't take any skill to apply it. And that's the other thing is because a lot of times you can have physicians in whether they're in the previous decade of learning or whatnot that are hesitant because they don't know how to apply the product or they don't know what the product is going to look like after it dissolves and the special things that they have to look for in the wound bed before they can go onto the next step.

(28:29):
And there's nothing like that in this product, which makes it very, very easy. And so not only can surgeons and wound care people use it, but you can use this in your family practice, in your rural settings where they're treating wounds or they're the ones who are taking out sutures from the ER visits and the trauma patients when they have an infected wound. And so it's something that can every type of physician or medical provider can use.

Brad Wiggins (28:55):
You mentioned all sorts of different types of wounds. You went from partial thickness to wound beds underneath a dermal substitute. You talked about using it on a closure of a stoma. You talked about a degloving injury. How are you dressing this when you put the product on? So for the audience that hasn't used it, what's your recommendations for over the top of it?

Dr. Weaver (29:15):
Yeah. So the biggest thing is putting it directly onto the wound bed after you've cleaned it. It doesn't have to be a clean wound bed in the sense of no exudate or anything like that. Just do a good cleaning. The moisture of the wound bed is going to allow it to adhere. If it doesn't adhere quite a bit, you can get a little moist, the wound bed, and it will adhere. And then after that, I really just try to stick a non-adherent dressing and some type of a wrap. If I'm going to something where I feel like the wound would benefit from some type of a dermal sub or a skin sub over it, then I make sure that I put the Pelashield® or the PainGuard® underneath that so it's directly on the wound bed, so it's doing its job in the wound bed.

(30:01):
In the beginning, I was a little concerned are my other products on top of this going to be able to do their job? And they definitely have, and it's because of the technology that it contours to the bed. And so it allows all of the products to be able to mold together and work. And so honestly, it's very easy. You can use any type of a dressing. I would say the only thing I avoid is any type of petroleum type of dressing over it, just so it can do its job in the wound bed.

Brad Wiggins (30:30):
In general, have you had to reapply the product a lot? You mentioned with the degloving case that you had that patient, that family reapply that a few times. Have you had to reapply it every three days? Are there some patients where you can do it less than that?

Dr. Weaver (30:44):
Oh yeah. So definitely based off of what I'm trying to get with the wound, also kind of how I will judge it is based off of the sheet size that I use. And so I want to use this product. I want them to use it all. And so if I feel like the wound is going to benefit and we have a little bit of the product left that we're not using, then I'll use it. I will not change it more than every three days. And there's been a lot of times where I'll only change it on a weekly basis if the family is able to get here on a weekly basis just to be able to see how the wound is progressing.

Brad Wiggins (31:20):
Yeah. And just to clarify, this is a long-term problem for all of us with wound care explanation. You don't change it. You just reapply a piece over the top of it, right? So that's a really nice feature, but I think we're so used to talking about what we do to a wound that we have to change something. This is a really unique opportunity to not have to change product. You can just simply lay a new piece down and you can wash it, do whatever you need to, and then put a new piece down if necessary. So I love that technology for sure. And I think that's one that really pays off down the pathway of success for these types of wounds. I'd be interested in knowing your thoughts about what the future of these fields look like. What are the opportunities that we still need to try to figure out to get best wound closure?

Dr. Weaver (32:03):
We're starting to see that less is more. And we have so many dressings out there that have silver impregnation in them, that even have these vank powders and all these different wounds. And it really goes back to your basics as far as if you can get the wound clean, it's eventually going to close. But if we can provide some type of a substance or something to where it's effectively helping us avoid the infections in these wounds, as well as allowing our wound bed to not be so chemically over sensitized to where it won't close and it's killing the wound bed and allowing it to do its job, that that's really where we're going to see the benefit. And so I think we're starting to see more and more of that where in the past we would use such harsh ingredients on these wounds. And so we would stop all type of wound closure because we've killed the cells, the cells that are growing.

(33:04):
And this doesn't do that at all. It helps actually activate the bed and help for those cells to regenerate and to grow, which helps all of our wounds. And so I think that's where we're going to start seeing down the road that we're starting to use more and more of this just in a normal basis, both in a prophylactic setting and in a salvage setting.

Brad Wiggins (33:26):
Dr. Weaver, thank you for walking us through how you think about pediatric burn and wound care. It's a perspective we don't get on this show often. And I think our listeners are going to get a lot out of this episode and really getting to know you a little bit better and ultimately why you focus on using the SAM technology for your patient population with and without the PainGuard® option with the lidocaine. To everyone tuning in, if you want to learn more about our SAMatrix™ technology and how it's being used in cases like the ones we've talked about today, head over to imbedbio.com, I-M-B-E-D-B-I-O.com, imbedbio.com and we'll link this also in all of your different platforms wherever you might be listening or watching this podcast. I'm Brad Wiggins. Thanks for spending this time with us on the Zero Zone and we'll see you next time.

(34:17):
Thanks for listening to the Zero Zone. I'm Brad Wiggins. If you found this conversation valuable, share it with someone on your burn or wound care team and subscribe on our YouTube channel. Links to everything we talked about on today's show are available in the show notes. To send us a message or to hear more episodes, go to zerozonepodcast.com. Learn more about Imbed Biosciences at imbedbio.com. I-M-B-E-D Bio.com.