Illustration by Lisa Clark.

What is Biodesign? Biodesign is a platform technology behind numerous tissue-repair products that span multiple medical specialties. Biodesign is natural extracellular matrix (ECM) derived from porcine small intestinal submucosa (SIS). The ECM is a complex latticework of proteins and structural molecules that helps guide the growth of cells.1 Cook’s proprietary processing methodology decellularizes the SIS material while preserving natural matrix molecules such as collagen, proteoglycans, and glycosaminoglycans.2 The result is a scaffold that, when implanted, provides a location for host cells...

How does Biodesign work? There are three essential components to healing: a scaffold, signals, and cells. Biodesign’s open lattice structure provides a scaffold for tissue ingrowth.3 Porcine small intestine, submucosa in blue. The body's signaling mechanisms help patient cells infiltrate the scaffold and completely remodel into natural host tissue. SIGNALS Extracellular matrix structure of lyophilized porcine small intestinal submucosa

Microscopic view of the remodeling process2 Biodesign graft prior to implantation 8 months after implantation The Biodesign graft (left) allows for the substantial growth of organized tissue, as seen in this biopsy sample, taken eight months after implantation (right). The above images are of the Biodesign Plastic Surgery Matrix implanted in breast tissue.4

What is the result? The result is a durable repair consisting of vascularized tissue. Placement of a Biodesign graft

40 days post-op 60 days post-op Images of endoscopic tympanoplasty provided by Dott. Giuseppe Panetti, December 2014, Ascalesi Hospital-ASL Napoli.

A proven technology. With more than 1,400 total published articles, Biodesign is one of the most well-studied graft technologies on the market.* Published OHNS studies* Randomized, controlled trials* *As of 1 May 2018.

• Alexander NS, Chaaban MR, Riley KO, et al. Treatment strategies for lateral sphenoid sinus recess cerebrospinal fluid leaks. Arch Otolaryngol Head Neck Surg. 2012;138(5):471-478. • D'Eredita R. Porcine small intestinal submucosa (SIS) myringoplasty in children: a randomized controlled study. Int J Pediatr Otorhinolaryngol. 2015;79(7):1085-1089. • James AL. Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope. 2017;127(11):2659-2664. • De Zinis LO, Berlucchi M, Nassif N. Double-handed endoscopic myringoplasty with a holding system...

Dural substitute Tympanoplasty Periodontal graft Cied pouches Staple line reinforcement Management of second-degree burns Enterocutaneous fistula Inguinal hernia Rectovaginal fistula Anal fistula Venous ulcers Diabetic ulcers Eyelid reconstruction Sinonasal repair Facial reconstruction Carotid patch Pericardial repair Hiatal hernia Peripheral nerve repair Parastomal reinforcement Ventral hernia Rectal prolapse Peyronie's repair Pressure ulcers

OTOLOGI C REPAI R GRAFT

1. Hubbell JA. Materials as morphogenetic guides in tissue engineering. Curr Opin Biotechnol. 2003;14:551-558. 2. Hodde J, Janis A, Ernst D, Zopf D, Sherman D, Johnson C. Effects of sterilization on an extracellular matrix scaffold: Part I. Composition and matrix architecture. J Mater Sci Mater Med. 2007;18(4):537-543. 3. Data on file. Cook Biotech Internal Report #D00199545. 4. Data on file. Cook Biotech Internal Report #D00199430. To learn more, visit cookmedical.com/otolaryngology. To contact us, visit cookmedical.com/connect.