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用于复杂上肢伤口重建的Novosorb可生物降解临时基质

Novosorb Biodegradable Temporizing Matrix for Reconstruction of Complex Upper-Extremity Wounds.

作者信息

Jou Christopher, Chepla Kyle J

机构信息

Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.

Division of Plastic Surgery, MetroHealth Hospital, Cleveland, OH.

出版信息

J Hand Surg Glob Online. 2024 Jul 2;6(5):614-618. doi: 10.1016/j.jhsg.2024.05.006. eCollection 2024 Sep.

Abstract

PURPOSE

Dermal matrices can be used in management of upper-extremity wounds to create vascularized wound beds in the setting of exposed bone or tendon. Early outcomes of Novosorb biodegradable temporizing matrix (BTM) demonstrated success when used in the treatment of complex wounds. We hypothesize that BTM is effective for reconstruction of upper-extremity wounds.

METHODS

A retrospective review was performed for patients who underwent reconstruction of upper-extremity wounds with BTM between January 2017 and May 2022.

RESULTS

In total, 51 patients (39 males and 12 females) were included. Wound etiology included trauma (n = 30), burn (n = 12), infection (n = 8), and vasopressor-related injury (n = 1). The average size of BTM was 162.5 cm, and the average time from BTM application to wound closure was 90.1 days. Twenty-seven (52.9%) patients required skin grafting, whereas 20 (39.2%) did not and re-epithelialized spontaneously. Those who did not require skin grafting had significantly smaller wound sizes compared to those who required skin grafting (58.5 cm vs 248.6 cm;  = .002). Complications occurred in 14 patients, including infection (n = 5), fluid collection (n = 5), and template dehiscence (n = 4). Wound closure was successful in 92% of patients.

CONCLUSIONS

Novosorb BTM is effective for the management of upper-extremity wounds with exposed bone and tendon.

CLINICAL RELEVANCE

In the management of complex upper-extremity wounds with exposed bone and tendon, even when devoid of paratenon or periosteum, Novosorb BTM provides a safe and effective alternative to more complex reconstructive options.

摘要

目的

真皮基质可用于上肢伤口的处理,以便在骨骼或肌腱外露的情况下形成血管化的伤口床。Novosorb可生物降解临时基质(BTM)用于治疗复杂伤口时的早期结果显示取得了成功。我们假设BTM对上肢体伤口的重建有效。

方法

对2017年1月至2022年5月间接受BTM重建上肢伤口的患者进行回顾性研究。

结果

共纳入51例患者(男性39例,女性12例)。伤口病因包括创伤(n = 30)、烧伤(n = 12)、感染(n = 8)和血管加压药相关损伤(n = 1)。BTM的平均面积为162.5平方厘米,从应用BTM到伤口闭合的平均时间为90.1天。27例(52.9%)患者需要植皮,而20例(39.2%)患者不需要,伤口自发重新上皮化。与需要植皮的患者相比,不需要植皮的患者伤口面积明显更小(58.5平方厘米对248.6平方厘米;P = .002)。14例患者出现并发症,包括感染(n = 5)、积液(n = 5)和模板裂开(n = 4)。92%的患者伤口成功闭合。

结论

Novosorb BTM对伴有骨骼和肌腱外露的上肢伤口的处理有效。

临床意义

在处理伴有骨骼和肌腱外露的复杂上肢伤口时,即使没有腱旁组织或骨膜,Novosorb BTM也为更复杂的重建选择提供了一种安全有效的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/054c/11456664/a9e8fab7c911/gr1.jpg

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