Skin and soft tissue reconstruction has long been based on the concept of reconstruction ladder. However, skin substitute has gained its role and become popular because it has predictable outcomes without donor sites morbidity. Biodegradable temporizing matrix (BTM; NovoSorb; PolyNovo Ltd) is a synthetic skin substitute and was recently introduced to Taiwan. Compared with other dermal templates, the clinical efficacy and performance of BTM are not well established, especially among Asian population. This study is aimed to share our experience of using BTM in various wound condition.
Materials and Methods.
Between Jan. 2022 and Oct. 2023, patients who underwent skin and soft tissue reconstruction with BTM were reviewed. Patient demographics, wound characteristics, surgical details, secondary procedures and complications were recorded.
Results.
Thirty-four patients were included, consisting of 13 females and 21 males with mean age of 52.5 years (range, 22–86 years). Wound etiologies included trauma (64.7%), burn (11.8%), necrotizing soft tissue infection (20.6%) and scar excision (2.9%). The mean BTM size was 54.5 cm2 (range, 22-180 cm2). Eight patients received concomitant flap surgery and BTM implantation. Nineteen patients (55.9%) underwent subsequent skin grafts while the other 15 patients had smaller wounds (20.8±11.8cm2) healed by secondary intension. The most common complication was infection (n=6 [17.6%]), and five of them were treated conservatively and only one required debridement. 30 over 34 patients (88.2%) had well BTM take while only 4 patients had BTM failure and required further reconstruction (2 additional skin substitutes, 2 flaps). At the last follow-up, 33 of 34 patients (97.1%) achieved successful wound closure with satisfactory scar condition. Vigorous wound debridement and negative pressure wound therapy might increase the BTM take rate and lower the complication.
Conclusions.
BTM is effective and feasible in treating various wounds with relatively low complication rates. BTM can be considered as an alternative in the skin and soft tissue reconstruction.