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Alex Parker, H de Berker, S Iyer, M Dalal, A Hamilton, J Srinivasan, C Ekwobi and S McKirdy
Lancashire Teaching Hospitals NHS Foundation Trust, UK
ScientificTracks Abstracts: Surg Case Rep
Background: NovoSorb™ Biodegradable Temporising Matrix (BTM™) is a novel synthetic, polyurethane bilayer dermal template. It is composed of a 2mm biodegradable and biocompatible porous matrix membrane, that allows for the infiltration of cellular material, with an overlying superficial temporary sealing membrane. This superficial membrane is designed to be removed after a period of weeks, revealing a fully neovascularised dermis ready for definitive autologous split skin graft (SSG) coverage. This case series details the use of BTM™ in the reconstruction of 22 different soft tissue defects and their reported outcomes. Method: Retrospective case series of patients from Lancashire Teaching Hospital Plastic Surgery department with a soft tissue defect, that was reconstructed using BTM™. Data collected included patient demographics; co-morbidities; indication for BTM use; anatomical area, depth, and total body surface area of defect; time from application of BTM™ to skin graft; method of fixation and dressing as well as percentage success and any complications. Results: 22 patients were identified with a variety of different soft tissue defects and aetiologies. Soft tissue defect TBSA ranged from <1% to 8% with a median of <1%. In many cases patients had significant co-morbidities. In all cases BTM was secured with sutures and dressed with a silver based non adherent dressing +/- NPWT. 18 patients had >90% successful graft take, 1 patient 70% graft take, 2 patient’s had complete graft loss and 1 patient not documented. Both graft failures were associated with pseudomonas positive wound swabs. Conclusion: BTM™ provides a robust alternative to flap reconstruction in patients with significant comorbidities, limited donor sites or when a less-invasive approach is preferred. Further larger, randomised studies are required to evaluate this novel technique compared against both its animal alternatives (e.g. Integra™) and more traditional reconstructive techniques with emphasise on resistance to infection, scar contracture and aesthetic outcome.
Abbreviations
BTM™ - Biodegradable Temporising Matrix
TBSA - Total Body Surface Area
NPWT - Negative Pressure Wound Therapy
SSG - Split Skin Graft.
Recent Publications :
1. Li H, Lim P, Stanley E, et al. Experience with NovoSorb® Biodegradable Temporising Matrix in reconstruction of complex wounds. ANZ J Surg. 2021;91(9):1744-1750.
2. Radtke C, Panzica M, Dastagir K, Krettek C and Vogt PM (2016) Soft Tissue Coverage of the Lower Limb following Oncological Surgery. Front. Oncol. 5:303.
Alex Parker is currently undertaking core surgical training in the North West of England with the aspiration to specialize in Burns & Plastics. He is a strong healthcare service professional with a Bachelor of Medicine, Bachelor of Surgery - MBChB from University of Liverpool as well as a Bachelor of Science - BSc in Molecular Medicine from University of Sussex.
