Unlike the body’s reparative healing response for deep wounds, which is chaotic, NovoSorb® BTM is unique in its ability to reorient the healing process from repair into regeneration. NovoSorb BTM is designed to promote the organized generation of a robust vascularized neodermis, designed to minimize scarring and contracture, thus improving functional and cosmetic patient outcomes. Continue reading to discover how NovoSorb BTM converts the body’s reparative healing process into regeneration.

Reparative versus Regenerative Healing

When small portions of the skin’s surface (epidermis) are destroyed, such as with superficial wounds (<1 mm), the body can—and does—heal by regenerating the damaged tissue. When large portions of the skin and its deeper layers (dermis) are destroyed, the body exceeds its capacity for regenerative healing and undergoes reparative healing.

The body’s reparative healing process is unorganized, rapidly closing the wound to protect it from further insult. This process involves laying down fibrotic tissue followed by months of remodeling and scar contraction that’s likely to contribute to poor wound healing and a progressive functional decline.

Reorienting the Reparative Process into Regenerative Healing

NovoSorb BTM’s biodegradable temporizing matrix breaks up a large (macro) wound into a series of interconnected small (micro) wounds (<1 mm in size), allowing the body to heal it as a small, discrete wound. Several characteristics are required of NovoSorb BTM to convert repair into regeneration. These requirements, along with the ways NovoSorb BTM satisfies each of them, are listed below.

Materials must:

– Seal the wound

– NovoSorb BTM’s outer sealing membrane provides temporary physiological wound closure, protecting the wound from external contamination, reducing evaporative moisture loss, [2] preventing tissue overgrowth, and supporting robustness in the presence of infection.³

– Minimize the inflammatory response to reduce scarring

– NovoSorb BTM is made of a synthetic biocompatible polymer that doesn’t stimulate an excessive foreign body response (FBR).

– Compartmentalize small wounds so they undergo regenerative healing

– NovoSorb BTM compartmentalizes a macrowound into a series of interconnected microwounds (<1mm).

– Not elicit a significant foreign body response (FBR)

– NovoSorb BTM is associated with a mild FBR, characterized by a thin layer of foreign body giant cells adjacent to the polymer.
– The physical foam architecture of NovoSorb BTM avoids capsule formation.

– Allow for cellular migration and neovascularization

– NovoSorb BTM’s matrix consists of a 94.2% porous architecture that provokes mechanical (kinetic) fluid flow.
– The matrix chambers (also known as matrix cells) are approximately 1mm in diameter, while the connecting pores average ~200µm.
– NovoSorb BTM slowly hydrolyses until it completely degrades and disappears, leaving behind a vascularized neodermis.

– Be bioabsorbable and biocompatible

– NovoSorb BTM is designed to stay in place as the body slowly heals. NovoSorb BTM’s matrix degrades over time via hydrolysis by natural pathways.[4]  
– As NovoSorb BTM hydrolyses, it forms products, including hydroxy-acids such as L-lactic acid, until it’s fully resorbed and excreted by the body within 18 months.[5]

– Minimize contracture

– NovoSorb BTM’s sealing membrane reduces evaporative water loss.
– Matrix struts prevent myofibroblasts from laying down a contiguous collagenous network beyond the confines of each chamber.
– Matrix struts retain microstructure and stay largely intact for 6+ months.

NovoSorb BTM’s attributes make it a versatile solution for use in the repair and reconstruction of a variety of complex wounds. If you’re a clinician exploring reconstructive options for major skin trauma, NovoSorb BTM may help you achieve improved outcomes. Reach out to our team of experts today at (302) 268-6163 to learn more about how NovoSorb BTM promotes regenerative healing in the body and is designed to reduce scarring and contracture associated with normal wound healing.

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] Solanki NS, York B, Gao Y, Baker P, Wong She RB. 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):1845-53.

[2] Greenwood JE, Schmitt BJ, Wagstaff MJD. Experience with a synthetic bilayer Biodegradable Temporising Matrix in significant burn injury. Burns Open. 2017; 2(1):17-34.

[3] Greenwood JE, Dearman BL. Split-skin graft application over an integrating, biodegradable temporising polymer matrix: immediate and delayed. Journal of Burn Care & Research. 2012; 33(1):7-19.

[4] Tatai L, Moore TG, Adhikari R, Malherbe F, Jayasekara R, Griffiths I, Gunatillake PA. Thermoplastic biodegradable polyurethanes: the effect of chain extender structure on properties and in-vitro degradation. Biomaterials. 2007; 28(36):5407-17.

[5] 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.