Integra has come out swinging, singling out BTM for a direct comparison study with its Dermal Regeneration Template product.
The findings have been published in
Design matters: A comparison of natural versus synthetic skin substitutes across benchtop and porcine wound healing metrics: An experimental studyThe authors, all employees of Integra, found that BTM has an average pore diameter four times larger than that of Integra’s collagen matrix, that BTM is hydrophobic whereas the collagen matrix is hydrophilic, that BTM is less conformable (stiffer) than the collagen matrix and that there is a significantly greater ability of fibroblast and keratinocyte adhesion and proliferation on collagen versus polyurethane.
It is argued that the larger pore size of BTM results in an altered collagen deposition that is typically associated with a fibrotic and contractile tissue response, although minimal contraction of BTM-treated wounds was observed in this experiment. The authors suggest that the minimal contraction seen with BTM was “likely owing to the continual presence of stiff polyurethane material throughout the wound both resisting contractile forces and providing a degree of disruption to collagen alignment”.
Because of its hydrophilic nature, it is reasoned that the Integra product should more readily absorb wound fluid, and hence immune cells, growth factors, etc. than BTM once implanted into a wound site, potentially deterring a foreign body response.
Further, the authors theorize that the lesser conformability of BTM could lead to gaps or in wound contact which could ultimately decrease successful engraftment of the matrix, leading to void spaces underneath the sealing membrane, potentially enhancing risk of hematoma, seroma, and infection.
Finally, it is argued that the superior fibroblast and keratinocyte adhesion and proliferation seen with Integra’s collagen matrix leads to better and faster wound healing.
https://onlinelibrary.wiley.com/doi/full/10.1002/hsr2.1462
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