Dr Hamed Amani1, Dr Sigrid Blome-Eberwein1, Dr Daniel Lozano1
1Lehigh Valley Regional Burn Center, Allentown, United States
Introduction:Reconstruction of complex wounds continues to be challenging and has traditionally relied on either tissue rearrangement or use of dermal matrices to restore the affected area. Where indicated, Integra® has been the go-to dermal substitute. We present a case series of complex wounds treated successfully with a new, polyurethane-based dermal matrix (NovoSorb® BTM; PolyNovo Biomaterials Pty Ltd).
Methods:NovoSorb BTM was used to help reconstruct full-thickness skin defects with application of split-thickness skin graft (STSG). In three cases, successful reconstruction over exposed bone and tendon was achieved.
Results:Defects created by electrical injury, thermal burn and necrotizing fasciitis were treated. In each case, the matrix adhered well, even when infection was suspected. In one case, multiple layers of NovoSorb BTM was used to fill in a defect on the face with great result. Reconstruction over exposed bone was also successful.
Discussion:Massive thermal, electrical and necrotizing infections result in devastating wounds, which may be difficult to reconstruct. Reconstruction choices are often limited to STSGs, flap closure, use of dermal matrix in conjunction with STSGs, or a combination. The advantage of NovoSorb BTM is its resistance to infection, unlike collagen-based dermal matrices. In our series, we have demonstrated the ability of NovoSorb BTM to bridge soft-tissue defects over tendon and bone previously only possible with the use of biologic dermal matrices.
Conclusion:This series is the first description of NovoSorb BTM used to reconstruct exposed bone and fill deep contour irregularities with use of multiple layers.
Dr. Hamed Amani is the Associate Medical Director of Lehigh Valley Regional Burn Center and an Assistant Professor of Surgery at the University of South Florida. The burn center is one of the busiest in America with over 1000 acute burn admissions per year. Dr. Amani has a BS in Chemistry and a BA in Philosophy. He is qualified in General Surgery, Trauma/Critical Care and Burn Surgery. He has published and regularly lectures on topics of burn surgery and burn disaster management.