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. 2022 Aug 2:22:e31.
eCollection 2022.

Head and Neck Wound Reconstruction Using Biodegradable Temporizing Matrix Versus Collagen-Chondroitin Silicone Bilayer

Shannon S Wu  1 , Michael Wells  2 , Mona Ascha  3 , Radhika Duggal  1 , James Gatherwright  4 , Kyle Chepla  5
Affiliations

Head and Neck Wound Reconstruction Using Biodegradable Temporizing Matrix Versus Collagen-Chondroitin Silicone Bilayer

Shannon S Wu et al. Eplasty. .

Abstract

Background: Head and neck reconstruction is challenging because of the functional requirements of movement, sensation, and cosmesis of this highly visible region. This study is the first to compare Novosorb biodegradable temporizing matrix (BTM) and Integra collagen-chondroitin silicone (CCS) skin substitutes for reconstruction of soft tissue head and neck wounds.

Methods: This retrospective review included adults who underwent wound reconstruction of the head/neck with either BTM or CCS between 2015 and 2020. Patient-level data, complications, and closure rates were compared.

Results: The review identified 15 patients: 5 who received BTM and 10 who received CCS. Mean age at dermal template placement was 55 (range, 28-79) years. Race, sex, smoking status, medical comorbidities, defect size, radiation history, prior surgeries, and follow-up time were not significantly different between groups. Wound etiologies for BTM and CCS included burn (40% vs 60%), trauma (20% vs 20%), surgical wounds (20% vs 20%), and skin cancer (20% vs 0%), respectively (P = .026). Skin grafts were placed in 8 (80%) wounds after CCS placement, compared with 3 (60%) after BTM (P = .670). Template reapplication was required in 2 (40%) BTM wounds and 3 (30%) CCS wounds (P = 1.0). Infection, hematoma, and seroma were comparable between groups, although skin graft failure was higher in the CCS group at 3 (37.5%) compared with 0 for BTM (P = .506). More secondary procedures were required after CCS placement (CCS, 1.9 ± 2.2; BTM, 0.9 ± 0.8; P = .090). Definitive closure in patients not lost to follow-up occurred in 4 (100%) BTM and 6 (75%) CCS cases (P = 1.0).

Conclusions: Head and neck wounds treated with BTM had comparable closure and complication rates as CCS bilayer and required fewer secondary procedures and skin grafts. These findings suggest that BTM is safe and efficacious for application in head and neck wounds and may be considered as an economical alternative.

Keywords: Integra; Novosorb; biodegradable temporizing matrix; dermal substitute; head and neck; wound healing.

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Conflict of interest statement

Disclosures: KC and JC are paid consultants for Polynovo Biomaterials but were not involved in data collection or analysis. None of the other authors have significant conflicts of interest with any companies or organizations whose products or services may be discussed in this article.

Figures

FIGURE 1
FIGURE 1
Patient selection flow diagram.
FIGURE 2
FIGURE 2
Skin graft requirements and achievement of complete wound closure rates in head and neck wounds compared between BTM and CCS.
FIGURE 3
FIGURE 3
Template infection, skin graft infection, and skin graft failure rates in head and neck wounds compared between BTM and CCS.
FIGURE 4
FIGURE 4
Template infection, skin graft infection, and skin graft failure rates in head and neck wounds compared between BTM and CCS.
FIGURE 5
FIGURE 5
Patient with a full-thickness burn injury to the entire face and scalp treated with BTM application. a) Initial burn injury prior to BTM application. b) BTM application on postoperative day 0. c) BTM take was observed in all areas without complications. d) The patient had skin-grafting after BTM application and achieved wound healing in all areas. Left eyelid ectropion is noted at 6 months postoperatively.
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