Most superficial wounds (ones involving the epidermis and sometimes the partial dermis) heal quickly, often without scarring, and typically covered with readily available wound dressings. However, when trauma occurs and large portions of the epidermis and dermis are destroyed, it may be necessary to put a structure in place to aid the body in generating new tissue. NovoSorb® BTM is a fully synthetic dermal matrix developed for the treatment of full-thickness wounds where the dermal structure has been lost due to trauma or surgical debridement. NovoSorb BTM may be used to physiologically close the wound and aid in generating a vascularized dermal layer (i.e., neodermis) in preparation for definitive wound closure. NovoSorb BTM’s bilayer matrix consists of a two-stage process: application of the biodegradable temporizing matrix (BTM) and delamination of the fenestrated sealing membrane.
Read on to learn more about this strategic process for successful wound closure.
BTM Application
In preparing the wound bed for NovoSorb BTM application, all nonviable tissue should be excised entirely (i.e., debridement), the wound needs to be free of infection, and effective hemostasis should be achieved. Once all unhealthy or dead tissue has been surgically removed, clinicians can move forward with NovoSorb BTM application. NovoSorb BTM is ready for application straight from the packaging, with no further preparation required.
The surgeon can cut NovoSorb BTM to fit the shape of the wound bed, apply it with the matrix side (sparkly side) facing down, and affix it with sutures or staples. The edges of the dermal template should be flush to one another (if more than one sheet is used) and against the wound sides.
BTM Integration
The appearance of NovoSorb BTM will progressively change over time as it integrates. Almost immediately, the dermal matrix fills with haemoserous fluid and then undergoes cellular migration with new blood vessel formation and collagen production (i.e., integration) over time. Through this process, the wound commonly changes appearance from a dark red (ingress of coagulated blood) to a brighter red (populated with adipocytes, fibroblasts, and blood vessels) to a uniform pink color (new dermal tissue) upon full integration. Integration time varies depending on the patient and wound characteristics. It may be assessed by performing a simple blanch test to demonstrate rapid capillary refill.
BTM Delamination
NovoSorb BTM can be delaminated in stages or all at once, [1] allowing for donor site regrowth, management of patient comorbidities, or lessening bodily stress. Once a clinician determines the tissue is fully integrated throughout the matrix, the sealing membrane can be gently peeled, detached, and discarded, leaving a vascularized dermal layer ready for definitive closure. The sealing membrane can remain in place even after integration has been achieved, providing flexibility to surgeons with timing of delamination. Definitive closure of the wound is at the discretion of the surgeon.
NovoSorb BTM’s matrix is biocompatible and initially retains its structure after application, and then slowly deteriorates over time as the body continues to heal. [2] To learn more about the benefits of NovoSorb BTM, visit our website at PolyNovo.com or contact one of our knowledgeable team members at (302) 268-6163.
Note: This document contains general guidelines and isn’t designed to replace existing institutional protocols or professional clinical judgment regarding patient care. Please refer to the NovoSorb BTM Instructions for Use.
References:
[1] Greenwood JE, Schmitt BJ, Wagstaff MJD. Experience with a synthetic bilayer Biodegradable Temporizing Matrix in significant burn injury. Burns Open. 2018;2(1):17-34.
[2] 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.