Dr James Briffa1, Dr Daniel Bunker1
1Launceston General Hospital, Launceston, Australia
Novosorb® Biodegradable Temporising Matrix (BTM) has been shown to be a useful tool for the reconstructive surgeon confronted with complex wounds, a paucity of autologous options and/or medically comorbid patients (1,2). Whilst allowing ingrowth of vasculature into the neodermal framework, BTM concurrently provides physiological wound closure by limiting transepidermal fluid loss via its silicone out layer.
We present the case of an 82-year-old man who underwent surgical debridement and subsequent application of BTM for a necrotising soft tissue infection of the upper arm. BTM was elected to provide a stable neodermis and cover exposed tendon in the volar forearm as well as the exposed olecranon. Due to delays with medical complications in hospital, delamination and grafting occurred at 10 weeks post BTM application. The BTM allowed for physiological closure of a large wound during this time, and subsequently augmented his result with a stable neodermis.
We also present a review of the current literature on the protracted application of BTM.
1. Wagstaff M, Salna I, Caplash Y, Greenwood J. Biodegradable Temporising Matrix (BTM) for the reconstruction of defects following serial debridement for necrostising fasciitis: A case series. Burns Open. 2019, 3, 12-30.
2. Cheshire P, Herson M, Cleland H, Akbarzadeh S. Artificial dermal templates: A comparative study of NovoSorb™ Biodegradable Temporising Matrix (BTM) and Integra® Dermal Regeneration Template (DRT). Burns. 2016: 42, 1088-1096.
Dr James Briffa in an unaccredited plastic and reconstructive surgery registrar at the Launceston General Hospital. He has an interest in hand surgery, burn surgery and medical military history.