The case series of Biodegradable Temporising Matrix (BTM) in the reconstruction axillary burns in paediatric patients
Sarah Huang1, Ling Hoon1, Claire Toose1, Stephanie Wicks1, Rachel D’Cruz1, 1Children’s Hospital Westmead, Sydney, NSW, Australia
Abstract
Background: NovoSorb® BTM (Biodegradable Temporising Matrix) is a synthetic polyurethane matrix that has been increasingly used in the treatment of deep burn injury (deep dermal and full thickness) to promote the generation of new dermis prior to skin grafting surgery. However, its long-term scar outcomes have not been well described, particularly across complex joints.
We compare two cases of axillary burns. Firstly, a case of an 8-year-old girl who suffered a deep flame burn to her left axilla and chest. BTM was applied post-initial debridement prior to delayed skin grafting 4 weeks later. We have found that despite intensive scar management, with extended periods of splinting and standard care with garments, silicon, this child has developed a band that requires a surgical release. Contrastingly, a case of a 9-year-old boy who had a flame burn to his right axilla and arm was treated with a split-thickness skin graft immediately after debridement. He has not shown to develop similar scar complications and has had excellent scar outcomes with standard therapy.
Hypertrophic scars were seen along the junction between BTM applied to burn skin and normal skin. Clinical photographs have been taken at different stages of the healing process to reflect these findings.
This case series aims to raise the discussion of long-term scar outcomes with the use of BTM on paediatric complex joints.
Biography
Dr Sarah Huang is a burns and plastics surgery registrar in Sydney.