Struble Sarah L, Patel Niki K, Graham Emily M, Tipps John A, Vaile John R, Leeflang Elisabeth J, Goodwin Isak, Mendenhall Shaun D
From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Pa.
Division of Plastic and Reconstructive Surgery, Department of Surgery, West Virginia University, Morgantown, W.Va.
Plast Reconstr Surg Glob Open. 2024 Jul 3;12(7):e5956. doi: 10.1097/GOX.0000000000005956. eCollection 2024 Jul.
NovoSorb biodegradable temporizing matrix (BTM) is a novel, bilayer, synthetic skin substitute made of biodegradable polyurethane foam covered with a sealing membrane. BTM has demonstrated excellent outcomes in burn literature; however, few studies have been published for hand and extremity soft tissue reconstruction.
All patients who underwent extremity reconstruction with BTM from 2018 to 2023 were reviewed. Demographics, presentations, and clinical outcomes were recorded.
A total of 86 cases from 54 patients (53.7% pediatric; age range: 0-81 years) were included. Common indications included trauma (36%), infection (18.6%), and malignancy (11.6%). BTM was placed over exposed tendon (38.4%), bone (19%), joints (12.8%), nerves (8.1%), and/or blood vessels (7%). BTM served as temporary wound coverage in 26 cases. Complications included hematoma (8.1%), infection (4.7%), and spontaneous delamination (4.7%). Wound closure was successfully obtained without flap use in 93.3%. Poor BTM take was associated with peripheral vascular disease, hypertension, immunosuppression, and BTM hematoma and infection (<0.05).
This study contributes to the growing body of evidence favoring BTM use in challenging reconstructive cases. Although prospective comparative studies are forthcoming, BTM likely has broad applications in reconstructive surgery.
NovoSorb生物可降解临时基质（BTM）是一种新型的双层合成皮肤替代物，由覆盖有密封膜的可生物降解聚氨酯泡沫制成。BTM在烧伤文献中已显示出优异的效果；然而，针对手部和四肢软组织重建的研究发表较少。
回顾了2018年至2023年期间所有接受BTM进行四肢重建的患者。记录人口统计学资料、临床表现和临床结果。
共纳入54例患者的86例病例（53.7%为儿童；年龄范围：0至81岁）。常见适应证包括创伤（36%）、感染（18.6%）和恶性肿瘤（11.6%）。BTM覆盖于暴露的肌腱（38.4%）、骨骼（19%）、关节（12.8%）、神经（8.1%）和/或血管（7%）上。BTM在26例中用作临时伤口覆盖物。并发症包括血肿（8.1%）、感染（4.7%）和自发分层（4.7%）。93.3%的病例在未使用皮瓣的情况下成功实现伤口闭合。BTM附着不佳与外周血管疾病、高血压、免疫抑制以及BTM血肿和感染相关（<0.05）。
本研究为支持在具有挑战性的重建病例中使用BTM的证据不断增加做出了贡献。尽管前瞻性比较研究即将开展，但BTM可能在重建手术中有广泛应用。
