PolyNovo was an exhibitor and Gold Sponsor at the 19
th European Burns Association Congress held in Italy from Wednesday to Saturday this week.
Tina Palmieri, Professor, Division of Burn Surgery at UC Davis in Sacramento California, which is one of the study locations for the current BARDA burns trial, delivered a lunchtime address titled
Clinical experience with BTM: what have we learned the past 5 years.Three abstracts related to BTM were presented:
Use of Novosorb BTM in combination with SSG in MEEK technique for covering chronic burn wounds at a child (P.074) was submitted by a team of surgeons from Cologne in Germany.
This case study concerned a 5 year old girl who had suffered chronic burn wounds in a gas explosion injury. Ten months after the accident she was admitted to hospital with scar contracture that was holding her chin at the chest, impairing movement of the neck. Scars without functional impairment also existed on her face and both legs.
Transverse incision of the skin contracture was followed by debridement of the wound and application of NPWT.
Novosorb BTM was used in combination with silver wound dressing. After delamination of the BTM, autologous SSG without expansion at the neck and axilla and SSG in MEEK technique for the other wounds was applied at day 25. Complete closure of the wounds was achieved on day 78.
The surgeons concluded that Novosorb BTM helps the healing of large burn wounds even in cases of chronic state with superinfection ( MRSA, pseudomonas, achromombacter). They noted that, as a synthetic material, BTM minimizes the risk of immune reactions or transmission of diseases.
Identification of independent risk factors for the treatment of third degree burns with the NovoSorb biodegradable temporizing matrix (BTM) in a multifactorial logistic regression analysis (P.110) was submitted by surgeons from the Trauma and Burns Centre, Ludwigshafen and the Department of Plastic Surgery, University of Heidelberg.
The surgeons reported on their 2 years’ experience with BTM in the treatment of 88 burn patients using a multifactorial logistic regression analysis.
Only third degree burns were treated with BTM.
The mean percentage of total body surface area burnt (% TBSA) was 18% (± 19.4, min 0.2%, max 95%) and an average of 4.8% TBSA (± 7.9, min 0.2%, max 49%) was treated with BTM. The mean period between the trauma and BTM application and subsequent skin transplantation was 13 days (± 14.4 days) and 30 days (± 6.6 days). The mean BTM and skin graft take was 84.8% (± 22.7%) and 86.3% (± 23%). Upon multifactorial binary regression analysis, BTM take (p=0.001), BTM infection (p=0.001), prior cadaver skin homograft (p=0.02), exposure of bone (p=0.01), diabetes mellitus (DM) (p=0.04) and peripheral artery disease (PAD) (p=0.01) proved to be independent risk factors for impaired BTM and skin graft take.
The surgeons concluded that good BTM take is the most important factor influencing skin graft take and that therefore early debridement and instant BTM application should be emphasized to avoid infection. They recommended that in cases with impaired vasculature of the wound bed, systemic or topic antibacterial treatment should be applied.
First experiences with a Polyurethane Biodegradable Temporising Matrix in wounds with complications (P.149) was presented by a doctor from Clinic Bergmannstrost, Clinic for Plastic and Hand Surgery in Halle, Germany.
This clinic in Halle has been using BTM for 2 years in complicated degloving and burns injuries. A total of 15 patients have been treated with BTM since May 2020. In the cases presented, complete wound closure was obtained with good cosmetic and functional results and without any infection.
Initial experiences with BTM were described as positive. It was observed that rate of infections was lower and that there was less need to use other materials. Scar quality was deemed to be better than with split skin only. The clinic intends to continue to use BTM in selected indications.
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