Kostova Mariana, Alexander Thomas D, De La Cruz Monroy Martha, Murdeshwar Himani, Duvnjak Haris, McCance Harriet C, Natalwala Ibrahim, Rahman Shafiq, Fredericks-Bowyer Lauren-Jane
Otolaryngology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR.
Otolaryngology, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, GBR.
Cureus. 2024 Dec 19;16(12):e75994. doi: 10.7759/cureus.75994. eCollection 2024 Dec.
The objective of this systematic review and meta-analysis is to assess the efficacy of the biodegradable temporising matrix (BTM) (NovoSorb; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) in the reconstruction of complex upper extremity wounds. The authors conducted a systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines assessing the efficacy of BTM in complex upper extremity wound reconstruction. The primary outcome measures were successful BTM integration and the proportion of wounds healed. Secondary outcomes analysed were the average time from BTM application to its integration, the proportion of wounds healed by secondary intention, graft take over BTM, as well as the incidence of infection. The rate of complications as well as scarring and outcomes in upper limb function were also evaluated. The inclusion criteria were met by 12 studies consisting of 164 complex upper extremity wounds. Successful BTM integration was reported in 92.1% (p<0.001) of cases, coupled with wound healing achieved in 90% (p<0.001) of cases overall. The average time to integration for BTM was 37.37 days (p<0.001). The average infection rate for upper extremity wounds with BTM application was 8.5% (p<0.001). Satisfactory scarring and functional outcomes were reported in the majority of the studies. The authors conclude that BTM offers good wound healing outcomes for upper extremity reconstruction. The studies analysed indicate good graft take rates and a low infection incidence; however, further prospective randomised studies are required to support the efficacy of BTM compared to other dermal matrices.
本系统评价和荟萃分析的目的是评估可生物降解临时基质（BTM）（NovoSorb；PolyNovo生物材料有限公司，澳大利亚维多利亚州墨尔本港）在复杂上肢伤口重建中的疗效。作者按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了一项系统评价和荟萃分析，评估BTM在复杂上肢伤口重建中的疗效。主要结局指标为BTM成功整合和伤口愈合比例。分析的次要结局包括从应用BTM到其整合的平均时间、二期愈合的伤口比例、BTM上的移植物存活情况以及感染发生率。还评估了并发症发生率以及上肢功能的瘢痕形成和结局。12项研究纳入了164例复杂上肢伤口，符合纳入标准。92.1%（p<0.001）的病例报告BTM成功整合，总体上90%（p<0.001）的病例实现了伤口愈合。BTM整合的平均时间为37.37天（p<0.001）。应用BTM的上肢伤口平均感染率为8.5%（p<0.001）。大多数研究报告了满意的瘢痕形成和功能结局。作者得出结论，BTM为上肢重建提供了良好的伤口愈合结局。分析的研究表明移植物存活率高且感染发生率低；然而，与其他真皮基质相比，需要进一步的前瞻性随机研究来支持BTM的疗效。
