Upper Extremity Wounds Treated with Biodegradable Temporizing Matrix versus Collagen-Chondroitin Silicone Bilayer

Shannon S. Wu; Michael Wells; Mona Ascha; James Gatherwright; Kyle J. Chepla

doi:10.1055/s-0042-1749077

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2023; 15(05): 340-350
DOI: 10.1055/s-0042-1749077

Original Article

Upper Extremity Wounds Treated with Biodegradable Temporizing Matrix versus Collagen-Chondroitin Silicone Bilayer

Shannon S. Wu

¹Department of Education, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States

,

Michael Wells

²Department of Education, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States

,

Mona Ascha

³Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

,

James Gatherwright

⁴Division of Plastic Surgery, Department of Surgery, Cleveland Clinic Akron General, Akron, Ohio, United States

,

Kyle J. Chepla

⁵Division of Plastic Surgery, Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio, United States

› Author Affiliations

Abstract

Objective This study aims to compare outcomes between Novosorb Biodegradable Temporizing Matrix (BTM) and Integra collagen-chondroitin silicone for upper-extremity wound reconstruction.

Methods This retrospective study analyzed adult patients who underwent wound reconstruction with either BTM or Integra at our institution between 2015 and 2020.

Results Forty-eight patients were included: 31 (64.6%) BTM and 17 (35.4%) Integra. Mean age was 44.0 (range: 18–68) years. Age, race, sex, smoking, comorbidities, and defect size were similar between groups. Wound etiologies included 12 (25.0%) burn, 22 (45.8%) trauma, and others. Median template size was 133 cm² for BTM and 104 cm² for Integra (p = 0.526). Skin grafting was performed after 14 (45.2%) and 14 (82.4%) wounds treated with BTM and Integra, respectively (p = 0.028). Template complications of infection and dehiscence were comparable. Skin-graft complications occurred in five (35.7%) and three (21.4%) wounds in BTM and Integra, respectively (p = 0.031). Skin-graft failure rates were comparable (p = 0.121). Mean number of secondary procedures required after template placement was higher in the Integra group (BTM, 1.0; Integra, 1.9; p = 0.090). Final healing was achieved in 17 (54.8%) BTM and 11 (64.7%) Integra wounds (p = 0.694). Median time to healing was 4.1 months after BTM and 2.6 months after Integra placement (p = 0.014).

Conclusion Compared with Integra, BTM achieved comparable wound healing and complication rates. Fewer secondary procedures and skin grafts were observed in BTM wounds, likely as a result of the coronavirus disease 2019 pandemic. At our institution, 100 cm² of product costs $850 for BTM and $3,150 for Integra, suggesting BTM as an economical alternative to fulfill the high functional and aesthetic requirements of upper-extremity wounds.

Keywords

Biodegradable Temporizing Matrix - dermal substitute - Integra - Novosorb - wound healing

Full Text

References

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