Dr Francesca Dudas1, Dr Fadie Aziz1
1Concord Repatriation General Hospital, Concord, Australia
Background: NovoSorb® BTM (Biodegradable Temporising Matrix) has revolutionised the treatment of full thickness burn injuries especially when they involve a large total body surface area or an area that would not usually be able to support a graft acutely. Our unit has extensive experience with the use of BTM however has never before used it to reconstruct fingers.
Methods: a patient with 64% TBSA full thickness flame burns including to the dorsum of both hands and all fingers underwent tangential excision of all burnt tissue and application of BTM prior to grafting.
Results: 100% take of BTM to all fingers and dorsal aspect of both hands – the patient had a second stage procedure in the form of a fenestrated sheet graft inset 3 weeks later which were also successful. The patient is able to move all of their fingers and has use of their hands.
Discussion: Our centre uses BTM in a number of settings including as a temporising dressing in systemically unwell major burns patient where immediate reconstruction is not possible. This is the first time we have used it in the reconstruction of fingers.
Conclusion: We have achieved successful reconstruction in our first major burns patient who underwent tangential excision, BTM application and subsequent split thickness skin grafting to all fingers. This is a single case study however is another promising application of a dermal substitute in the reconstruction of a critically unwell patient to preserve function and cosmesis.
I am a plastic and reconstructive surgery unaccredited registrar in Sydney. I am currently the burns registrar for a major burns centre.