Reconstruction of a Complex Paediatric Scalp Friction Burn with NovoSorb(R) BTM
Kate Lindley1, Sandeep B Helen Douglas Tim Hewitt 1Perth Childrens Hospital, Nedlands, WA, Australia
Abstract
NovoSorb® Biodegradable Temporising Matrix (BTM) offers a valuable reconstructive solution for surgeons presented with complex wounds (Li et al., 2021). Significant scalp tissue defects are considered complex due in part to the sparsity of soft tissue between the epidermis and underlying skull, as reconstructive options over exposed bone are limited (Desai et al., 2015). Since its registry with the TGA in 2018, BTM has provided a safe, and minimally-invasive reconstructive alternative for these complex wounds. Limited case studies have also shown successful reconstruction in the setting of wound infection (Patel et al., 2022).
AIM: To contribute to the small body of clinical evidence surrounding the use of BTM in complex scalp wounds. The patient: BC, a five-year-old Indigenous male from a rural WA town, suffered significant friction burns with a large degloving component to his scalp in the context of a pedestrian vs car polytrauma. The complex pattern and extent of scalp injury complicated by wound infection, caused initial attempts at primary closure to fail, and precluded local flap reconstructive alternatives. BTM was applied, then delaminated and covered with a STSG on day 29. Early graft checks have revealed impressive wound healing (90% graft uptake on day 5). Ongoing outpatient follow up will continue to monitor progress (D10 post-grafting on submission). Promising early wound outcomes support using BTM on complex scalp wounds, particularly in the context of prior wound infection.
Desai, S.C. et al. (2015) ‘Scalp reconstruction’, JAMA Facial Plastic Surgery, 17(1), pp. 56–66. doi:10.1001/jamafacial.2014.889.
Li, H. et al. (2021) ‘Experience with novosorb® biodegradable temporising matrix in reconstruction of complex wounds’, ANZ Journal of Surgery, 91(9), pp. 1744–1750. doi:10.1111/ans.16936.
Patel, N.K. et al. (2022) ‘Reconstruction of a near-total scalp avulsion with NovoSorb biodegradable temporizing matrix: Pediatric case report’, Plastic and Reconstructive Surgery – Global Open, 10(12), pp. 1–3. doi:10.1097/gox.0000000000004717.
Biography
PRS + Burns surgical service registrar at WA’s primary Paediatric burns centre, Perth Children’s Hospital.