.png)
Case Series/Study
A bilayer synthetic polymer matrix was recently introduced to the United States for the treatment of open wounds. This product is of proven importance in burn care. The authors investigated its effectiveness in managing of a diversity of wounds.
Methods:
The woven side of this product is placed on the wound. It is fixed in place and covered by a negative pressure dressing. Due to its synthetic composition, it is highly resistant to infection and can stay on the wound for as long as it is needed. Patients (23) included a variety of complex reconstructions: 1 Fournier’s gangrene, 1 Facial acne keloidalis excision, 2 scalp wounds, 2 axillary hidradenitis, 2 pressure ulcers, 6 hands, and 9 lower extremity acute and chronic wounds.
Results:
The hand and leg wounds with exposed tendon achieved coverage without tethering. The scalp wounds developed a neodermis and were skin grafted. A pyoderma gengrenosum patient with excessive slough and uncontrolled bleeding was temporarily immunosuppressed, aggressively debrided and covered with the matrix. Her bleeding resolved. She developed a neodermis and had reduced symptoms. The Fournier’s patient had immediate skin grafting of his penis and testicles, but the remaining extensive perineal and upper thigh wounds were treated with the matrix and healed without additional skin grafting. A hand patient with a forearm fasciotomy wound was covered with the matrix. As the swelling resolved the size of the defect decreased to the point that the wound was delaminated. The adjacent skin was elevated and used to cover the open area, achieving full closure. There were no complications attributed to the use of the matrix. Several patients healed secondarily with the silicone sheeting gradually peeling off. 7 patients had or are awaiting skin grafts to be placed onto their neodermis.
Discussion:
Although this is an early review of the use of this synthetic matrix in the US, it comes with a positive legacy of safety and effectiveness during the 15 years of use in Australia. Findings thus far indicate that there is a wide range of applications for this product well beyond burn care. Its safety record, resistance to infection and ease of use was confirmed by our experience. This product facilitates surgical wound management.
Trademarked Items: BTM, Biodegradable Temporizing Matrix
References: Li A, Dearman BL, Crompton KE, et al. Evaluation of a novel biodegradable polymer for the generation of dermal matrix. J Burn Care Res. 2009: July-Aug (9):717-28.
Greenwood JE. The evolution of acute burn care – retiring the split thickness skin graft. Ann R Coll Surg Engl 2017:99 (6): 432-438.
Greenwood JE. Burn Injury and Explosions: An Australian Perspective. ePlasty 2009 Sep 16;9:e40.