Novosorb Biodegradable Temporizing Matrix for Reconstruction of Complex Upper-Extremity Wounds

Purpose: Dermal matrices can be used in management of upper-extremity wounds to create vascularized wound beds in the setting of exposed bone or tendon. Early outcomes of Novosorb biodegradable temporizing matrix (BTM) demonstrated success when used in the treatment of complex wounds. We hypothesize that BTM is effective for reconstruction of upper-extremity wounds.

Methods: A retrospective review was performed for patients who underwent reconstruction of upper-extremity wounds with BTM between January 2017 and May 2022.

Results: In total, 51 patients (39 males and 12 females) were included. Wound etiology included trauma (n = 30), burn (n = 12), infection (n = 8), and vasopressor-related injury (n = 1). The average size of BTM was 162.5 cm², and the average time from BTM application to wound closure was 90.1 days. Twenty-seven (52.9%) patients required skin grafting, whereas 20 (39.2%) did not and re-epithelialized spontaneously. Those who did not require skin grafting had significantly smaller wound sizes compared to those who required skin grafting (58.5 cm² vs 248.6 cm²; P = .002). Complications occurred in 14 patients, including infection (n = 5), fluid collection (n = 5), and template dehiscence (n = 4). Wound closure was successful in 92% of patients.

Conclusions: Novosorb BTM is effective for the management of upper-extremity wounds with exposed bone and tendon.

Clinical relevance: In the management of complex upper-extremity wounds with exposed bone and tendon, even when devoid of paratenon or periosteum, Novosorb BTM provides a safe and effective alternative to more complex reconstructive options.