The Clinicians Speak, page-937

From DW
Fes

A new BTM article has just been published by authors from the Division of Plastic Surgery, University of Rochester Medical Center,Rochester, NY, USA.

I talked about this article at the Macquarie Bank conference in Sydney last week

1. Olsen T, Ali-Khan Safi, Bell D.

Comparative analysis of animal-derived vs fully synthetic acellular dermalmatrices in reconstructive surgery: An examination of clinical,aesthetic, and economic measures.

Annals of Plastic Surgery. 2024; 92(4S):S172–8.

https://doi.org/10.1097/SAP.0000000000003909

This is a single-centre, retrospective study comparing the outcomes of 26 patients treated with NovoSorb BTM (15 cases) versus Integra Dermal Regeneration Template (IDRT) (11 cases). In all cases, a split-thickness skin graft was applied with the aim of achieving definitive wound closure.

The aim of the study was to compare the functional, aesthetic, and economic outcomes of using BTM and IDRT to treat soft-tissue wounds of varying aetiologies.

Statistical analysis of the operative data included the following results:

1. Mean surgery time was significantly shorter in BTM cases.
2. Mean post-op hospital stay was significantly shorter for BTM placement.
3. Median time to wound closure was significantly shorter for BTM placement with a trend towards reduced time to 100% skin graft take using BTM.
4. Complete skin graft take on first attempt was significantly greater for BTM and was achieved in 100% of BTM cases versus 63.6% of IDRT cases.
5. Incidence of infections was significantly different between the treatment groups with no BTM cases versus 36.4% of IDRT cases.
6. Significantly higher incidence of hypertrophy (raised scars) in IDRT versus BTM.
7. Failure of the template showed a trend towards being higher in the IDRT group (27.3%) versus BTM group (0%).
8. Significantly more revision surgeries for IDRT than BTM.
9. Improved pigmentation, vascularity and pliability scar scores for BTM than IDRT.

The cost of devices per unit area was much lower for BTM than IDRT. The mean net profit (amount charged by hospital for use of device minus the device cost to hospital) was higher for IDRT than BTM.

(Note that such comparisons depend on local pricing and surgical reimbursement policies, and therefore may differ between hospitals and healthcare systems.)

The authors conclude:

“Our findings reveal thatalthough profit per square centimeter may favor IDRT, the ancillary benefits ofBTM–such as reduced hospital stay, shorter surgery times, fewer outpatientvisits, and quicker wound closure– substantially enhance overall cost-effectiveness,endorsing institutional adoption.

This comparative analysissuggests enhanced clinical efficacy and optimized resource use with BTM. Wehighlight the functional, aesthetic, and economic benefits of BTM compared withIDRT placement in treating extensive soft tissue defects.”

This looks like the most comprehensive comparison and analysis of BTM versus IDRT that I have seen to date.