PNV - Banter and General Comments, page-10602

Huh! "pyrimid" ???? Inventing new English or sub-normal thinking??

You want evidence, see what our great Chairman DW sent out today in an email.

Email as follow:
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What’s not to like about a product with these impactful lifesaving benefits?

A new BTM article has just been published by authors from the Department of Plastic Surgery and Burns, Royal Preston Hospital, Preston, UK:

1. Parker A, de Berker H, Kiely A, Iyer S, Dalal MD, Srinivasan JR, Ekwobi CC, McKirdy SW.

The use of NovoSorb™ Biodegradable Temporising Matrix (BTM™) in the reconstruction of complex soft tissue defects — an oncological, aesthetic, and practical solution.

European Journal of Plastic Surgery. 2023; 27 September

This article presents a retrospective analysis of a case series of 24 complex soft tissue defects in 23 patients from a single institution. Indications included:

1. reconstruction post-infection debridement
2. post-cancer resection
3. chronic wound reconstruction
4. burns
5. free flap failure
6. surgical wound dehiscence

There was complete BTM integration in 96% (23/24) of wounds including a variety of wound beds and exposed structures including bone, cartilage, muscle, tendon, and fat In 1 case of a partially failed deep inferior epigastric perforator (DIEP) flap for breast reconstruction, the first BTM application had to be removed as further necrotic tissue required debridement. However, BTM integration was successful following a second application.

The authors reported the successful use of BTM in a cohort of patients with significant underlying co-morbidities. With 48% suffering from severe systemic disease, they found that BTM reduces the need for a general anaesthetic. It reduces the expenditure of donor tissue in comparison to flap reconstruction, limiting the risk of donor site morbidity as well as the operative time and peri-operative recovery. By temporising the wound over a period of weeks to months, it facilitates a controlled, planned reconstruction in patients who first require medical optimisation.

In 22 defects, a split thickness skin graft was used, with a full thickness skin graft used for the other two. Twenty wounds demonstrated graft take greater than 90%. One wound demonstrated only 70% graft take, with the 30% region successfully managed conservatively with dressings, eventually undergoing re-epithelialization, and healing completely. Lastly, there were 2 wounds in which SSG take was entirely unsuccessful (i.e. 100% graft failure). In both cases, Pseudomonas aeruginosa was grown on microbiology wound swabs (pre-BTM and pre-SSG).

Robustness in the presence of infection was clearly demonstrated with 10 of 17 swabs having positive findings. Despite this, in 16 cases SSG take still exceeded 90%.

Specific details of 5 cases are included (most with accompanying images) for indications of trauma with failed free tissue flap, necrotising fasciitis, tumour excision with sequential BTM layering to restore a contour defect, and full-thickness burn.

In summary, the authors conclude:

“We have demonstrated the efficacy and adaptability of BTM in a variety of settings.

It provides a safe, reliable, and aesthetic alternative to free flap reconstruction in patients with significant comorbidities, limited donor sites or when a less-invasive approach is preferred.”

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For full article: https://link.springer.com/article/10.1007/s00238-023-02126-5#:~:text=Alternative%20to%20autologous%20reconstruction&text=This%20case%20series%20has%20demonstrated,with%20significant%20underlying%20co%2Dmorbidities.