Case Studies

The following case studies illustrate the effectiveness of NovoSorb® BTM. The studies are provided with consent from the patient and their surgeons. They are intended for educational use only. To view testimonials from patients whose lives have been changed by BTM, please visit Changing Lives

  • Trauma

    • Foot Trauma

      Traumatic crush injury of the foot with extensive exposed avascular structures

      • New Orleans
      • United States

      Patient’s right foot was pinned under a moving railroad car resulting in a severe crush injury. Injuries included full avulsion of all dorsal soft tissue, all 5 digits, and plantar aspect sparing the heel, as well as amputation of the 1st-5th distal phalanges. A below knee amputation (BKA) was initially recommended. Risks and benefts of BKA versus salvage were discussed and the decision was made to save the limb.

      NovoSorb BTM was applied over exposed bone, tendon and muscle, secured with staples and dressed in NPWT. Patient was ambulatory on postoperative day (POD) 2. BTM showed signs of vascularisation without infection at POD 17. At day 30, skin graft was applied with 100% graft take. The avoidance of an amputation greatly impacted the patient’s self-image and he is ambulatory with minimal usage of a cane.

    • Hand Trauma

      Re-epithelialisation of hand trauma after BTM application

      • Cleveland
      • United States

      Patient was involved in a traumatic motor vehicle roll-over injury with several open fractures/ dislocations on three fngers. Soft-tissue debridement of devitalised tissue was performed with NovoSorb BTM applied directly over exposed bone, joint, and tendon. BTM was applied initially as a temporising dressing until more complex reconstruction options could be explored. Early vascularisation without infection led to a decision to follow patient clinically. At day 41 following delamination, the wounds spontaneously re-epithelialised before scheduled skin grafting. At the 3-month follow-up there was no tissue breakdown and the patient was able to avoid further reconstructive surgery.

    • Foot Trauma

      Degloving injury to right foot with exposed tendons

      • Adelaide
      • Australia

      Patient sustained a traumatic degloving injury to their right foot. Soft-tissue debridement of the dorsum of the foot performed, with exposure of the deep structures. Free flap tissue surgery was deemed unacceptable to the patient due to associated risk and donor site morbidity.

      NovoSorb BTM was applied after second-look debridement on Day 3 and regular dressing changes were performed twice weekly. At 9 weeks BTM was delaminated and split-thickness skin graft applied. Seven months after grafting the skin displayed excellent conformity, and range of motion was restored with no tethering of the underlying tendons.

  • Infectious Diseases

    • Necrotising Fasciitis

      Large complex wound of anterior neck and chest after necrotising fasciitis infection

      • Adelaide
      • Australia

      After feeling unwell with flu-like symptoms for one week, the patient presented to hospital and was diagnosed with Necrotising Fasciitis. After debridement was performed from the bottom of chin down to chest and pre-pectoral areas, the patient was left with a large complex wound. Primary grafting was decided against due to concerns around neck contractures and restricted range of motion.

      NovoSorb BTM was applied and regular dressing changes were performed twice a week. After 4 weeks BTM was delaminated and the areas grafted. The skin grafts were successful with near full range of motion and the patient resumed full-time work within three months of incident.

  • Chronic Wounds

    • Pharyngocutaneous Salivary Fistula

      Chronic salivary fistula unable to be closed for 75 days

      • Christchurch
      • New Zealand

      A 67 year old Caucasian male, non-smoker developed a salivary fistula after carcinoma of the vocal cord. After multiple attempts to close, there remained an open wound after 75 days. Negative Pressure Wound Therapy was not an option due to the patient having a laryngeal stoma.

      After debridement NovoSorb BTM was applied with quilting staples. A silver dressing was applied and dressing changes were performed every 2-3 days to keep the area clean. At 3.5 weeks, BTM was delaminated and a split-thickness skin graft was applied, resulting in a successful closure of the wound.

    • Infected DFU

      BTM retained in infected DFU of the foot

      • Auckland
      • Australia

      Patient developed a wound on her foot from minor trauma. Due to her diabetes and comorbidities, the wound failed to heal, developing into an infected diabetic foot ulcer (DFU). Serial debridement was performed, and she was left with a large defect on the dorsum of her foot with exposed tendons that was not suitable for skin grafting alone. NovoSorb BTM was applied, dressed and topical negative pressure wound therapy (NPWT) applied. The patient was discharged after 1 week to a care facility.

      Problems with the NPWT were encountered. The patient was re-admitted with clinical evidence of infection that was systemically treated. The NovoSorb BTM was able to be retained despite the infection. Removal of the sealing membrane was performed at 4.5 weeks, a split-thickness skin graft applied, and the patient went on to heal uneventfully.