Use of a Synthetic Dermal Matrix for Reconstruction of 55 Patients with Nongraftable Wounds and Management of Complications

Abstract

The aim of this study was to investigate the role of a completely synthetic dermal matrix (Biodegradable Temporising Matrix) for staged reconstruction of complex wounds. The authors defined complex wounds as wounds not amenable to reconstruction with skin grafting alone due to an inherent avascularity such as the presence of bare bone, tendinous or neural structures. A retrospective review of a prospectively maintained database of complex wounds as defined above was carried out. 55 patients were identified who underwent staged Biodegradable Temporising Matrix and autologous skin graft reconstruction for complex wounds affecting a wide variety of patient demographics, treatment indications and body sites. Wound aetiology included burn injury and non-burn related trauma such as degloving injury or infective complications. Caveats relating to successful application of staged dermal matrix reconstruction, techniques, tips, prevention and management of complications are outlined. This large consecutive case series, demonstrates the integral role dermal substitutes play in providing biological wound cover for avascular wound beds which may otherwise require complex distant flap or free tissue transfer for reconstruction. Staged synthetic dermal matrix reconstruction has proven robustness in the face of unfavourable wounds compared with non-synthetic dermal matrices, physiologically covering avascular structures, allowing for early graft take, expediting rehabilitation and mobilisation with good scar cosmesis and limited contracture formation.

NovoSorb® Biodegradable Temporizing Matrix: a novel approach for treatment of extremity avulsion injuries in children

“…These results go hand in hand with the published literature describing BTM as a fully synthetic option for the treatment of deep tissue defects in adults and burns [29]. All patients in the study underwent the two-stage surgical procedure described in detail for adults [26,31,32,35].…”

Monolayer acellular dermal matrix for reconstruction of face burn: A case report

“… 7 While literature addressing facial burns is limited, there has been a noticeable emergence of studies evaluating ADM usage in this context over the past five years. 8 …”

Wound Management of Pediatric Burns

“…Many times, dermal substitutes (Integra or BTM) can be placed, and tendons will vascularize over the ensuing weeks. 40 41 Autografts can then be successfully placed. When skull is exposed, burring the outer table will allow for granulation tissue to grow from the viable marrow.…”