Dr Francesca Dudas1, Dr Fadie Aziz
1Concord Repatriation General Hospital, Concord, Australia
Objectives: To evaluate the use of ARTISS fibrin sealant as an adjunct to haemostasis prior to the application of biodegradable temporising matrix (BTM) in reconstructive burns surgery.
Methods: This is a case series of two patients who were admitted to a burns centre for surgical management. Intra-operatively, ARTISS was topically applied to the tissue bed prior to the application of BTM.
Results: Patient 1 had initial loss of BTM secondary to haematoma formation between the tissue and BTM preventing integration despite haemostasis at time of surgery. During revision surgery, ARTISS was used as an adjunct to the BTM which had 100% integration and the patient has subsequently had a successful split thickness skin graft. Patient 2 had successful integration of BTM to full thickness defects to the dorsal aspects of their hands and fingers bilaterally. This patient also has 100% integration of BTM without haematoma formation.
Discussion: Tissue approximation is crucial for the integration of BTM. Haematoma is a common source of failure if haemostasis is not achieved. In the case of Patient 1, a delayed bleed led to the initial loss of BTM. At a second revision surgery ARTISS was used with great success.
Conclusion: BTM loss is costly to both the hospital and to the patient. This centre has had success in the use of ARTISS as an adjunct to achieving haemostasis in ensuring the integration of BTM prior to grafting.
I am a plastics and reconstructive surgery unaccredited registrar in Sydney currently working as the burns registrar at Concord Hospital.