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Early outcomes using a novel bilaminar dermal regenerative template for treatment of complex upper extremity wounds
Yuewei Wu-Fienberg
James Gatherwright
Kyle J. Chepla
Case Western Reserve University
2019-01-29
Presenter: Yuewei Wu-Fienberg
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.
Director Name: Anand Kumar
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background: Upper extremity soft tissue defects with full-thickness skin loss and exposed tendon and/or bone often require flap reconstruction. In this study, we retrospectively reviewed patient outcomes with Novosorb BTM (PolyNovo, Wilmington DE), a novel bilaminar dermal regenerative template, and skin grafting as an alternative to flap reconstruction in these patients.
Methods: All patients treated with Novosorb BTM after upper extremity trauma were included. The product was applied after surgical debridement of all non-viable tissue. Patients were discharged on a five-day course of oral antibiotics, and the wound was assessed weekly. If necessary, split-thickness skin grafting was performed once the neodermis was revascularized.
Results: Six patients (4M:2F) with an average age of 49.8 (35-60) with exposed tendon and/or bone were included in the study. The etiologies of the wounds were: hand injuries related to motor vehicle accidents in three patients, radial forearm free flap donor site, industrial press injury, and full thickness hand burns. Average defect size measured 97cm2 (10-440 cm2). Average time to complete healing was 45 (27-57) days. One patient underwent grafting as early as 13 days following application. Three patients re-epithelialized spontaneously and did not require grafting; average defect size in these patients was 26cm2 (10-42 cm2). There were no complications, and no patients required further surgical intervention.
Conclusions: Novosorb BTM is a dermal regenerative template that can potentially serve as an alternative option to flap reconstruction in select patients after upper extremity trauma and soft tissue defects with exposed tendon and/or bone.
