The Australian and New Zealand Burn Association (ANZBA) held its Annual Scientific Meeting in Melbourne last week.
PolyNovo was a sponsor and Novosorb BTM was the subject of multiple presentations, posters and papers. A list, with some excerpts, can be found below.
PolyNovo Sponsored Dinner
Towards Zero: Optimising the science and patient outcomes with NovoSorb BTM
Progressing outcomes with NovoSorb BTM: A paediatric burns centre’s experience
Swami Raote | PolyNovo CEO
A/Professor Warwick Teague | Director of Trauma, RCH
Two small islands and Novosorb® BTM: Telehealth across the Pacific
Rebecca Schrale1, Andrew Castley1, Scott Buadromo2, Ravniel Singh3, Mereia Seru3, Sarika Karan3,
1Tasmanian Burns Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia
2Labasa Hospital, Labasa Fiji
3Fiji Burns Unit, Colonial War Memorial Hospital, Suva Fiji
Results & Conclusion:
At the time of submitting this paper, we have successfully treated two paediatric patients with BTM and continue to follow their progress through telehealth. This paper will discuss the challenges and the lessons learned from Telehealth and the results of the initiative.
Managing burns in a low resource hospital setting: experiences from Fiji, and the first Pacific Islands Novasorb BTM trial
Scott Buadromo
Dr Buadromo was the Fijian surgical lead in the recent trial of PolyNovo BTM in Fiji – the first time for use of this product in the Pacific Islands to address burns injury
Reflections on 5 years of experience with BTM reconstruction at the New Zealand National Burn Centre
Paul Baker1, Lindsay Damkat-Thomas1, Victoria Lo1, Richard Wong She1,
1Te Whatu Ora – Counties Manukau, Auckland New Zealand
Approximately 250 reconstructive cases using BTM have been performed. …
Limitations of the product in our experience are described, including less predictable integration on certain defects and anatomical locations. Total length of stay is increased with use in smaller TBSA burns, however we have found that ICU length of stay is reduced in comparison to our previous model of care.
Advantages reported with BTM include improved quality of reconstruction and predictability of graft take on less favourable wound beds. Furthermore, the presence of wound infection is usually tolerated by BTM and integration proceeds. We have also found increased flexibility when scheduling cases reconstructed with BTM during phases when our centre has been over our surgical capacity, and this conferred a significant advantage when we were faced with a burn mass casualty event.
5-year experience of BTM reconstruction in paediatric burns
Paul Baker1, Victoria Lo1, Lindsay Damkat-Thomas1, Mohammad Nassimizadeh Richard Wong She1,
1Te Whatu Ora – Counties Manukau, Auckland New Zealand
BTM was introduced into our practice in 2018. Since that time, we have used this product in 15 paediatric cases (16 years and under) and over 230 adult patients….
We present our experience with this product and helpful “tips and tricks” for its management based on our combined experience and will highlight differences in the paediatric population. We observe earlier time to grafting when compared to our adult burn population. We observe improved cosmetic results however increased length of stay when used in smaller burn injuries. BTM is also a useful reconstructive option in massive burn injuries with limited donor site availability and in mass casualty situations.
The role of dermal substitutes and facial aesthetic subunits in burn scar resurfacing
Sinem Gultekin1, Elizabeth Concannon2, Lauren Middleton2, Nicholas Solanki2, John Greenwood2,
1Royal Hobart Hospital, Hobart, Tasmania, Australia
2Adult Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Conclusion:
Dermal matrices such as BTM play an important role in secondary facial burn scar resurfacing and may achieve excellent results when managing deep burns affecting this cosmetically sensitive location.
Neck scar contracture release and resurfacing with synthetic dermal substitute – tips and tricks for success
Elizabeth Concannon1, Marcus Wagstaff1, Nicholas Solanki1,
1Royal Adelaide Hospital, Adelaide, South Australia, Australia
This single centre case series reports lessons learned from 5 patients who underwent neck burn scar contracture excisional release and staged resurfacing with a synthetic dermal substitute known as biodegradable temporising matrix. Operative, anaesthetic and rehabilitation techniques to maximise outcomes, optimise cosmesis and minimise contracture recurrence are discussed.
10-year review of paediatric patients with massive burn injury at the New Zealand National Burn Centre
Victoria Lo1, Paul Baker1, Lindsay Damkat-Thomas1, Richard Wong She1,
1Te Whatu Ora – Counties Manukau, Auckland New Zealand
We conducted a 10-review review of massive (>70% TBSA) paediatric burn injured patients referred to the NBC…
Reconstructive strategies have evolved over the years. Temporary wound cover with allograft was initially exclusively used, however Biodegradable Temporising Matrix has been a more recentaddition to wound temporisation. Definitive skin closure has progressed from rounds of widely meshed autografting with allograft overlay to BTM combined with Meek grafting….
The limit of what is deemed to be a survivable TBSA in our unit has increased….
How does BTM work? – Synthetic Graft Interactions in Full-Thickness Wounds Using Mouse Models
Nicole Garcia1,2, Mostafiz Rahman1,2, Ilia Banakh1,2, Cheng Lo1,2, Heather Cleland1,2, Shiva Akbarzadeh1,2,
1Skin Bioengineering Laboratory, Monash University, Melbourne, Victoria, Australia
2Victorian Adult Burns Service, The Alfred, Melbourne, Victoria, Australia
Experimental results from the full-thickness ungrafted wounds were compared to wound grafted with BTM. Results: Inflammatory markers peaked during inflammation in an ungrafted full-thickness wound. Haematoxylin and eosin staining demonstrated less inflammatory cells in grafted wounds compared to ungrafted wounds. Collagen deposition was significantly higher in wounds grafted with BTM. Wound contraction was significantly lower in wounds grafted with BTM. Inflammatory markers were downregulated in grafted wounds compared to ungrafted, and RNA fold expression of remodelling markers were higher in synthetically grafted wounds. Conclusion: Spontaneous wound repair is altered by the application of BTM. Data so far indicates that it does so in all stages of wound repair.
The case series of Biodegradable Temporising Matrix (BTM) in the reconstruction axillary burns in paediatric patients
Sarah Huang1, Ling Hoon1, Claire Toose1, Stephanie Wicks1, Rachel D’Cruz1,
1Children’s Hospital Westmead, Sydney, NSW, Australia
We compare two cases of axillary burns. Firstly, a case of an 8-year-old girl who suffered a deep flame burn to her left axilla and chest. BTM was applied post-initial debridement prior to delayed skin grafting 4 weeks later. We have found that despite intensive scar management, with extended periods of splinting and standard care with garments, silicon, this child has developed a band that requires a surgical release. Contrastingly, a case of a 9-year-old boy who had a flame burn to his right axilla and arm was treated with a split-thickness skin graft immediately after debridement. He has not shown to develop similar scar complications and has had excellent scar outcomes with standard therapy.
Reconstruction of a Complex Paediatric Scalp Friction Burn with NovoSorb(R) BTM
Kate Lindley1, Sandeep B Helen Douglas Tim Hewitt
1Perth Childrens Hospital, Nedlands, WA, Australia
The patient: BC, a five-year-old Indigenous male from a rural WA town, suffered significant friction burns with a large degloving component to his scalp in the context of a pedestrian vs car polytrauma. The complex pattern and extent of scalp injury complicated by wound infection, caused initial attempts at primary closure to fail, and precluded local flap reconstructive alternatives. BTM was applied, then delaminated and covered with a STSG on day 29. Early graft checks have revealed impressive wound healing (90% graft uptake on day 5). Ongoing outpatient follow up will continue to monitor progress (D10 post-grafting on submission). Promising early wound outcomes support using BTM on complex scalp wounds, particularly in the context of prior wound infection.
Zero Footprint Burn Care: How Biodegradable Dressings are Revolutionising Wound Management
Jeremy Bishay1, Isobel Yeap1, Aruna Wijewardana1, Bishoy Soliman1,
1Severe Burns Injury Unit, Royal North Shore Hospital, St Leonards , NSW, Australia
Biodegradable dressings are a superior alternative to traditional dressings due to their eco-friendliness and reduced waste production….
Another biodegradable dressing, BTM, serves as a temporary skin substitute and reduces the need for extensive autograft harvesting, minimising donor site morbidity. BTM aids in integrating skin grafts by eliminating non-viable tissue, promoting granulation tissue formation, and acts as a scaffold to prevent wound contraction and excessive scar tissue formation
Early experience of BTM in acute and reconstructive paediatric burns
William Crohan1, Samantha Lee1, Sarah Bache1, Suzanne Rea1, Fiona Wood1, Helen Douglas1,
1Perth Children’s Hospital, Nedlands, WA, Australia
Since 2019 our team has exclusively used NovoSorb® Biodegradable Temporising Matrix (BTM) in acute and reconstructive burns….
BTM is a new product available and reconstruction of burns patients and those patients who experience full thickness loss of skin. In comparison to its predecessor Integra, the current study suggests that BTM potentially offers a safer, more robust graft with resistance to infection.
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