The Efficacy of Biodegradable Temporising Matrix for Upper Limb Reconstruction: A Systematic Review and Meta-Analysis

The objective of this systematic review and meta-analysis is to assess the efficacy of the biodegradable temporising matrix (BTM) (NovoSorb; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) in the reconstruction of complex upper extremity wounds. The authors conducted a systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines assessing the efficacy of BTM in complex upper extremity wound reconstruction. The primary outcome measures were successful BTM integration and the proportion of wounds healed. Secondary outcomes analysed were the average time from BTM application to its integration, the proportion of wounds healed by secondary intention, graft take over BTM, as well as the incidence of infection. The rate of complications as well as scarring and outcomes in upper limb function were also evaluated. The inclusion criteria were met by 12 studies consisting of 164 complex upper extremity wounds. Successful BTM integration was reported in 92.1% (p<0.001) of cases, coupled with wound healing achieved in 90% (p<0.001) of cases overall. The average time to integration for BTM was 37.37 days (p<0.001). The average infection rate for upper extremity wounds with BTM application was 8.5% (p<0.001). Satisfactory scarring and functional outcomes were reported in the majority of the studies. The authors conclude that BTM offers good wound healing outcomes for upper extremity reconstruction. The studies analysed indicate good graft take rates and a low infection incidence; however, further prospective randomised studies are required to support the efficacy of BTM compared to other dermal matrices.