The Use of NovoSorb BTM for Trauma Reconstruction: Illustrative Cases and a Proposed Decision-making Tool

Abstract

Achieving a functional and aesthetic reconstruction following complex trauma is a challenge. Skin substitutes, including acellular dermal matrices, and newer, synthetic options such as NovoSorb biodegradable temporizing membrane (BTM) have given the reconstructive surgeon a useful tool where autologous options have been exhausted, are inappropriate, or would present a suboptimal reconstruction. This case series describes 6 patients admitted to an urban level I major trauma center between July and December 2022. All patients underwent complex reconstructive lower limb surgery using BTM as either a primary or salvage option. In each case, this approach was chosen on a case-by-case basis where it was felt BTM would offer a reconstructive advantage, or where primary reconstructive options had been exhausted. Data were collected retrospectively from case notes. Three patients received BTM as a primary reconstructive option. BTM integrated successfully in all 3. Three patients received BTM as a salvage option. In 1, the exposed fracture site was successfully bridged, and in another, BTM was successfully reapplied over exposed fracture site where BTM had previously failed to incorporate. Although BTM is a relatively new tool in the reconstructive surgeon's armamentarium, requiring further research into long-term outcomes, cost-effectiveness, and patient satisfaction, it can be a useful and versatile tool.

Fig. 1.

Patient 4 fully weight-bearing on the reconstructed left limb.

Fig. 2.

Distal third open tibial/fibular fracture with exposed medial malleolus fracture (arrow).

Fig. 3.

Fully integrated BTM shown bridging exposed bone and fracture before SSG.