Using BTM is a fairly low risk treatment as it is more resistant (or less susceptible) to infection compared to the current biologics in use. If it doesn't work you haven't lost anything (except for time) and leaves option B, C etc still on the table. Evidence of this is the case study of the man who would have otherwise had an amputation. The risk of infection (and subsequent failure of biologics) is higher so surgeons may have deemed the level of risk is not acceptable and therefore not considered dermal substitutes as a viable treatment option in the past. Polynovo is changing the rules!!
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