Affiliation:
1. University Hospital Limerick, Ireland
Abstract
This case study series outlines the use of Novosorb biodegradable temporising matrix (BTM, PolyNovo, Australia) in the management of 22 patients, each with a complex wound who attended the vascular department in the University Hospital Limerick between 2021 and 2023. The majority of patients presented with acute conditions (e.g. necrotising fasciitis, crush injuries, compartment syndrome) that initially required high dependency level care. The majority of wounds (21/22, 95%) affected the leg or foot, and one wound was on the chest wall. Each patient had a significant complex wound and, in many cases, was complicated further by the patients' medical condition and comorbidities, which had the potential to cause problematic and delayed healing. The BTM was applied following debridement, as required, and provided a stable base for secondary wound healing or skin grafting, as needed. Of the patients: 12 (54%) healed completely; one (4%) progressed towards complete vascularisation with the BTM in situ; two (9%) underwent major amputations despite successful application of the BTM to lower limb wounds; and one (4%) returned to theatre to have retained clips removed. The remaining six (27%) patients failed to heal completely following BTM application. Ischaemia, infection, vasculitis and underlying osteomyelitis were limiting factors in achieving limb salvage or healing. Declaration of interest: The authors have no conflicts of interest to declare.