Originally sent by DW today, it just goes to show why BTM is top...

Originally sent by DW today, it just goes to show why BTM is top of the surgical pops in Germany.

This article was recently published by authors from the Department of Hand, Plastic and Reconstructive Surgery, University of Heidelberg, Germany.

• Tapking C, Thomas BF, Hundeshagen G, Haug VFM, Gazyakan E, Bliesener B, Bigdeli AK, Kneser U, Vollbach FH.

NovoSorb® Biodegradable Temporising Matrix (BTM): What we learned from the first 300 consecutive cases.

Journal of Plastic, Reconstructive & Aesthetic Surgery. 2024; 92:190-7.

This paper reports on a retrospective analysis of the first 300 consecutive cases involving the use of NovoSorb BTM in patients with a variety of wound aetiologies.

The objectives of the study were to evaluate the efficacy of BTM in different wound types and to determine factors that may affect the success of treatment.

There is a lot of data reported in this paper. Here are some highlights.

Wound aetiologies evaluated were:

• burns (59.7%)
• trauma (19.7%)
• pyogenic infections (14.7%)
• tumours (2%).

The mean BTM and skin graft take rates were 82.7% and 86.0%, respectively. A major positive predictor of skin graft take rate was BTM take rate, as expected.

Previous use of allograft for temporary wound coverage had a negative influence on BTM and skin graft take rates. The previously reported potential for allografts to create a contaminated wound may partly explain this result. This hospital has evolved their practice towards early BTM application rather than allograft for large burn wounds.

The exposure of structures such as tendons and joint capsule did not negatively affect BTM and skin graft take rates.

Co-morbidities such as diabetes, peripheral artery disease and high BTM yielded less favourable outcomes. This is consistent with the known challenges of wound healing in the patients.

Smoking was not found to affect BTM or skin graft take rates.

Potential benefits of using BTM over other dermal substitutes or treatments identified by the authors include:

• No donor site morbidity for the initial surgery
• Easy application and wound care
• Low complication rates which make the use suitable for patients with multiple comorbidities. In such patients, BTM can be a rescue option or alternative to amputation.

The authors conclude:

“We present the largest cohort of patients who were treated with BTM.

We were able to show that complex wounds of different sizes and aetiologies that do not qualify for immediate split-thickness skin grafting can be treated successfully with BTM and lead to satisfactory results in terms of high take rates of both BTM and skin graft.”

The strengths of this study include:

• Large number of consecutive patients, meaning that there were no specific exclusion criteria and the data provides real-world evidence in a representative patient population.
• A variety of wound types evaluated, not just a single indication.
• Assessment of BTM and skin graft take rates included in the analysis, which is commonly only included as part of formal clinical studies.
• Consistency of study findings with published literature.