Systematic Review and Meta-analysis of Biodegradable Temporizing Matrix Application for Complex Wound Reconstruction

Biodegradable Temporizing Matrix (BTM) is a synthetic dermal template recently developed to reconstruct complex wounds. Current literature describes BTM outcomes in the presence of infection and other comorbidities but is limited by small sample sizes. The purpose of this systemic review and meta-analysis was to determine the current breadth and success of BTM use for complex wound closure. Databases were searched to identify previously published studies describing BTM use in human wounds. Studies were excluded if conducted in vitro, using nonhuman animals, or for procedures irrelevant to wound care. A total of 24 studies met the inclusion criteria, representing 202 patients. The most common injury treated with BTM was burns (68 cases, 33.7%) followed by acute surgical wounds (59 cases, 29.2%). The large majority of patients did not experience any postoperative infections (76.6%). Infected wounds were associated with a 7.5-day delay from BTM to grafting. Univariate regression analyses showed a negative association between time to BTM implantation and age, exposed muscle, and exposed tendon (p < 0.001). In total 92% of patients received BTM implantation less than 2 weeks from admission. A total of 84% of patients had a greater than 95% BTM take. The median time to split-thickness skin graft (STSG) was 34 days, and 92% of patients experienced a greater than 95% STSG survival. To our knowledge, this is the first reported systemic review on the application of BTM for wound reconstruction. According to the published data, BTM is a versatile dermal template for complex wounds coverage with a low risk of infection, high template take rate, and excellent autograft survival.