Masterclass GUIDES

What Is the Evidence?

Synthetic Dermal Matrix: NovoSorb® BTM

NovoSorb® BTM has been the subject of numerous studies and trials, and is well evidenced for efficacy, resistance to infection and cost effectiveness.

Efficacy Infection

■ In a study to explore the potential of NovoSorb® BTM in full-thickness burns patients, Greenwood et al. treated five participants between the ages of 18 and 70, with the device

■ The participants had between 20 and 50% Total Body Surface Area (TBSA) full-thickness burns

■ The BTM was secured using staples and dressed with dressing changes twice a week, with treatment culminating in a skin graft

■ All participants survived and recovered. The scarring in these participants was assessed after a period of six months from time of injury, with excellent results indicated by the scar assessment scales used3

■ Since this early study, there have been many reports by other authors on the clinical effectiveness of NovoSorb® BTM across a range of clinical indications7,8,9

■ The synthetic nature of this device gives it an obvious and significant advantage over biologicallyderived alternatives; the product does not feed bacteria because of this property and it does not have the same risk of immunorejection

■ Sreedharan et al. writes on the successful use of this product in the treatment of large wounds of high risk of infection, involving exposed tendons

■ “Over this (21 day) period, the BTM became gradually more hyperaemic and vascularised. Twenty-four days after implantation the BTM’s surface sealing layer was ‘delaminated’, revealing a vascularised matrix. The right leg anterior compartment tendons were no longer exposed. The wounds were then reconstructed...”8

Costs

■ Again, this device is synthetic and does not have a biological origin like most of the products which would be the natural choices for use in the treatment of similar wounds and reconstruction

■ The costs involved in producing the biologically-derived alternatives can be significant, and NovoSorb® BTM is therefore typically available at lower prices, or at least equivalent to cost effective alternatives10

“In each case, our experience of its application, evaluation of integration and split skin graft application, along with the management of complications such as sub-seal infection and haematoma, has steadily increased our confidence in its use.”

Greenwood et al., 2018

“We find the material safe, easy to use, monitor and delaminate. Graft loss over the BTM is extremely unusual.”

Greenwood et al., 2018

“In contrast to other dermal matrices where infection often leads to failure of the material, early infection was able to be successfully treated and the BTM salvaged with a combination of topical wound care and antibiotics.”

Solanki et al., 2020

Synthetic Dermal Matrix: NovoSorb® BTM

Key Points

■ Simple and easy application

■ Converts macro wounds to organised micro wounds

■ Designed to minimise contracture

■ Synthetic but biodegradable

■ Requires no preparation, besides cutting to size

■ Can be applied over any viable tissue, including complex wounds

■ No need for tissue tracking

■ Available in large sizes (up to 20x40cm)

■ Robust in the presence of infection

References

1. Greenwood JE, Dearman BL. Comparison of a sealed, polymer foam biodegradable temporising matrix against Integra(R) dermal regeneration template in a porcine wound model. J Burn Care Res. 2012; 33:163-73.

2. Dearman BL, Li A, Greenwood JE. Optimization of a polyurethane dermal matrix and experience with a polymer-based cultured composite skin. J Burn Care Res. 2014; 35(5): 437- 48.

3. Greenwood JE, Schmitt BJ, Wagstaff MJD. Experience with a synthetic bilayer Biodegradable Temporising Matrix in significant burn injury. Burns Open. 2018;2(1):17-34.

4. Wagstaff MJD, Schmitt B, Caplash Y, Greenwood JE. Free flap donor site reconstruction: A prospective case series using an optimized polyurethane temporising matrix. Eplasty. 2015; 15:231-48.

5. NovoSorb® BTM [Internet], Melbourne Australia: PolyNovo; [cited 8 June 2022]. Available from: https://polynovo.com/product-btm/

6. Wagstaff MJD, Schmitt BJ, Coghlan P, Finkemeyer JP, Caplash Y, Greenwood JE. A biodegradable polyurethane dermal matrix in reconstruction of free flap donor sites: a pilot study. ePlasty 2015; 15:102-18.

7. Solanki N, York B, Gao Y, Baker P, Wong She R. A consecutive case series of defects reconstructed using NovoSorb Biodegradable Temporising Matrix: Initial experience and early results. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020;73(10):1845-1853.

8. Sreedharan S, Morrison E, Cleland H, Ricketts S, Bruscino-Raiola F. Biodegradable temporising matrix for necrotising soft tissue infections: a case report. Australasian Journal of Plastic Surgery. 2019;2(1):106-109

9. Wu SS, Wells M, Ascha M, Gatherwright J, Chepla K. Performance of biodegradable temporizing matrix vs collagen-chondroitin silicone bilayer dermal regeneration substitutes in soft tissue wound healing: a retrospective analysis. Wounds. 2022;34(4):106-115.

10. Health Technology Assessment. [Internet]. Adelaide, Australia: South Australian Policy Advisory Committee on Technology (SAPACT); [cited 19 May 2022]. Avavailble from: https://www.sahealth. sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/health+technology+assessment+ hta+decision+summary+-+novosorb

11. Instructions for Use, NovoSorb BTM [Internet]. Melbourne Australia: PolyNovo; [cited 19 May 2022]. Available from : https://eifu.polynovo.com/

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