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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 
1   Department of Education, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States
,
Michael Wells
2   Department of Education, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
,
Mona Ascha
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
James Gatherwright
4   Division of Plastic Surgery, Department of Surgery, Cleveland Clinic Akron General, Akron, Ohio, United States
,
Kyle J. Chepla
5   Division of Plastic Surgery, Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio, United States
› Institutsangaben
Funding This study was funded internally. There are no other funding sources to disclose, including NIH, Wellcome Trust, HHMI, or others. The author(s) received no financial support for the research, authorship, and/or publication of this article.
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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

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). For a retrospective study, formal consent is not required.


Authors' Contribution

M.A., K.C., and J.G. were responsible for conception and design; K.C. and J.G. were responsible for administrative support; K.C. and J.G. were responsible for the provision of study materials or patients; S.W. and M.W. were responsible for collection and assembly of data; S.W. and M.A. were responsible for data analysis and interpretation; all authors were responsible for manuscript writing; and all authors were responsible for final approval of manuscript.


Abbreviations

BMI, Body mass index


BTM, Biodegradable Temporizing Matrix


CCS, Collagen-chondroitin silicone


EMR, Electronic medical record


FDA, Food and Drug Administration


IQR, Interquartile range


SD, Standard deviation


STSG, Split-thickness skin graft


Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).


Statement of Informed Consent

No informed consent was required for this study. Informed consent was waived for all patients and no identifying patient information is in this article.




Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2022

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