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Published on: August 8, 2020
A case series to evaluate burn therapy practices after application of Biodegradable Temporising Matrix (BTM)
Bradley Schmitt1, Kathryn Heath1, Marcus Wagstaff1,2
1Adult Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Objective:
Evolution in the use of Biodegradable Temporising Matrix (BTM) in our adult burn service prompted an evaluation of our therapy guidelines.
Method:
We conducted a retrospective case note review of adult burn patients who received BTM between March 2022 and September 2024. Data collected included commencement timing of range of motion (ROM) and ambulation after BTM application, burn and BTM total body surface area (%TBSA) and reason for any BTM loss.
Results:
The study included 22 patients (23 procedures). Overall, median burn TBSA was 30% with median BTM TBSA of 22% (BTM range 0.1%-70% TBSA). All patients had BTM crossing at least one upper limb (UL) or lower limb (LL) joint. Median time to ROM initiation after BTM was 4.5 days for UL and 2.0 days for LL. Median time to ambulation was 1.0 day overall. Among LL BTM patients intubated for < 7 days, ambulation commenced at a median of 1.5 days. Larger LL BTM areas (>10% TBSA) were slower to mobilise than smaller (<10% TBSA) areas (median 2.5 vs 1.0 days). Partial BTM loss occurred in six cases (26%), though none were attributed to therapy interventions.
Conclusion:
Therapy guidelines in our burns unit now recommend initiating gentle ROM within 3-5 days after BTM application, and ambulation from day 2-3, even in patients with large LL BTM areas, without negatively impacting BTM integration or timing to SSG.
