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Comparison of Biodegradable Temporizing Matrix and Collagen-Chondroitin Silicone Bilayer Dermal Regeneration Substitutes
Shannon S Wu BA, Michael Wells MEng, Mona Ascha MD, James Gatherwright MD, Kyle Chepla MD
MetroHealth Medical Center
2021-01-31
Presenter: Shannon S. Wu
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: James Gatherwright, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose
To compare Novosorb® Biodegradable Temporizing Matrix (BTM) and Integra® collagen-chondroitin silicone (CCS) skin substitutes for wound reconstruction.
Methods
This single-center, retrospective study analyzed adult patients who underwent wound reconstruction with either BTM or CCS between January 2015 and July 2020. Variables of interest included: demographics, wound characteristics, perioperative details, and outcomes and complications. Descriptive statistics and non-parametric comparison tests were performed when appropriate.
Results
Ninety-seven patients were included: 51 (52.6%) BTM and 46 (47.4%) CCS. Race, sex, smoking, comorbidities, defect size, radiation, and prior surgeries were similar. Wound etiologies included burn, trauma, surgical wounds, osteomyelitis, and compartment syndrome (p=0.051). Median template size was 147 cm2 and 100 cm2 in BTM and CCS, respectively (p=0.337). Skin grafts were applied after template in 39 (84.8%) CCS compared to 28 (54.9%) BTM (p=0.006), with the remainder of wounds healing secondarily. Template complications were comparable between groups; however, skin graft failure was higher in the CCS group at 9 (23.1%) compared to 1 (3.6%) (p=0.006). More secondary procedures were required in the CCS group (CCS, 1.9±1.8; BTM, 1.0±0.9; p=0.002). Final closure was achieved in 31 (60.8%) BTM and 28 (60.9%) CCS cases (p=0.655). Mean time to closure was 5.4±3.8 months after BTM and 6.4±8.9 months after CCS placement (p=0.591).
Conclusion
Compared to CCS bilayer, the new-generation skin substitute BTM has comparable complication rates and outcomes with fewer secondary procedures and skin grafts needed. Per 100 cm2, BTM costs $850 compared to $20,325 for CCS, suggesting BTM as an economical option for wound reconstruction.
