Authors (including presenting author) :
Ting WCJ, Wong TW, Chiu TW
Affiliation :
Burns Centre, Prince of Wales Hospital
Introduction :
Extensive burns results in a loss of the essential physical barrier for patients and therefore bacterial infections are very common. The generally recognised rate of death in burns patient is as high as 42%–65% of which patients with infections are twice as likely to die compared to patients without infections. Patients with extensive burns are haemodynamically unstable, surgery often requires massive transfusion and there are often no skin donor sites available initially. These burns patients are often debrided early to rid the body of the necrotic skin and then the wounds are covered with various dressings to allow the patient to stabilise. These dressings include cadaveric skin, simple dressings and dermal matrices. Novosorb Biodegradable Temporizing Matrix (BTM) is a fully synthetic polyurethane bilayer matrix that was developed in Australia back in 2004. The first use on humans was in 2015. Much like other dermal matrices, BTM provided a framework that allowed for the growth of a neodermis. This property is integral in patients who have deep to full thickness burns and would have the full thickness of their skin debrided. Traditional matrices are made of a mixture of synthetic and biological material and it is the biological material which is thought to be the cause of infection of the matrix. This can often lead to failure, early removal of the dermal matrix, systemic infection and even death of the patient. The unique property of BTM over other traditional matrices is that it is purely synthetic in nature. This means it is much more resistant to infection than other dermal matrices that are made from a mixture of synthetic and biological material. We first used BTM in 2022 in Hong Kong and have been the largest user for managing burns patients.
Objectives :
Our study examines the use of BTM in our Burns Centre in patients from 2022 to 2025. We looked at the results of patients who had BTM applied for both acute burns and reconstructive surgery.
Methodology :
We did a retrospective study of all the patients who were treated at the Burns Centre of Prince of Wales Hospital between 2022 when it was first introduced to 2025.
Result & Outcome :
A total of 20 patients were identified with 12 patients having acute burns and 8 patients with burns requiring reconstruction. The majority of patients were females and the average age of the patients was 49 years old with the range being 5 to 91 years of age. The most common presentations were flame and scald injuries. The total body surface area involves ranged from 3% to 35% burns of which almost half of the patients involved burns over 15% of their body total surface area. In the patients with reconstruction, the majority were for resurfacing the head and neck region and for important functional joints. 1 patient died and 1 patient was lost to follow up. We present their journey with BTM which include monitoring, intensive care of the surgical wound, evaluating the effectiveness and their current functional and aesthetic results.
