Reflections on 5 years of experience with BTM reconstruction at the New Zealand National Burn Centre
Paul Baker1, Lindsay Damkat-Thomas1, Victoria Lo1, Richard Wong She1, 1Te Whatu Ora – Counties Manukau, Auckland New Zealand
Abstract
The New Zealand National Burn Centre provides care for adult and paediatric burn injured patients. BTM first became available to us in 2018, and over the past 5 years we have increased our experience with this template predominantly in the acute but also in the elective setting.
Approximately 250 reconstructive cases using BTM have been performed. We discuss our technique for optimising outcomes when using this product. We discuss decision making in relation to managing collections, haematomas and appearances concerning for non-integration.
Limitations of the product in our experience are described, including less predictable integration on certain defects and anatomical locations. Total length of stay is increased with use in smaller TBSA burns, however we have found that ICU length of stay is reduced in comparison to our previous model of care.
Advantages reported with BTM include improved quality of reconstruction and predictability of graft take on less favourable wound beds. Furthermore, the presence of wound infection is usually tolerated by BTM and integration proceeds. We have also found increased flexibility when scheduling cases reconstructed with BTM during phases when our centre has been over our surgical capacity, and this conferred a significant advantage when we were faced with a burn mass casualty event.
We reflect upon the impact of this product on our model of care over the past 5 years.
Biography
Consultant Burns and Plastic Surgeon