Use of a synthetic biodegradable temporising matrix after necrotising fasciitis infection of the thigh

Abstract

Biodegradable temporising matrix (BTM NovoSorb; PolyNovo, Melbourne, Australia) is a novel synthetic polyurethane dermal substitute. Licensed in Europe in 2020, it was developed primarily for reconstruction of infected wounds. We present a case of a healthy man in his 60s with necrotising fasciitis of his left thigh. His medical history was significant for recurrent left thigh liposarcoma that was treated years earlier with surgical excision and adjuvant radiotherapy. The affected area was within the previously irradiated tissue, debrided down to fascia and dressed with a vacuum-assisted closure to help regenerate the wound bed. Reconstruction options were limited by having a circumferential thigh defect that was infected. Following the use of NovoSorb BTM, the area was dressed with Acticoat Flex 7 antimicrobial barrier dressing for 5 weeks. Patient mobilisation was permitted. The material integrated very well and formed a soft, pliable healthy dermal layer that was autografted with split thickness skin grafts. This resulted in durable cover of the thigh with good aesthetic contour and minimal contracture.

Keywords: Infections; Plastic and reconstructive surgery; Skin.