A Biodegradable Polyurethane Dermal Matrix in Reconstruction of Free Flap Donor Sites

A Pilot Study

Marcus J.D. Wagstaff, BSc(Hons), MBBS, PhD, FRCS(Plast), FRACS; Bradley J. Schmitt, BAppSc, MPhys; Patrick Coghlan, MBBS; James P. Finkemeyer, BBioMedSci, BMBS; Yugesh Caplash, MBBS, MS, MCh, FRACS; John E. Greenwood, AM, BSc(Hons), MBChB, MD, DHlthSc, FRCS(Eng), FRCS(Plast), FRACS


ePlasty. 2015;15 

In This Article


This is an account of the first 10 patients to receive BTM as a dermal scaffold up to the point of 1 year or death due to unrelated events. Patients tolerate the polyurethane during this time and integration occurs after variable lengths of time, dependent on donor site and patient condition. Integrated BTM can sustain split-skin graft after its delamination and dermabrasion. Areas of nonintegrated BTM did not sustain split-skin graft, and further time to integration appears necessary over tendons. Subseal collections of fluid necessitated partial delamination of the seal to allow fluid escape (in 2 cases culture positive for bacteria). In 3 cases, partial removal of the full thickness of the BTM was necessary due to underlying muscle necrosis, wound infection, or seroma over which adherence and integration had not occurred. Remaining BTM can, however, subsequently persist and integrate to support skin graft-take. Wound contraction appears to stabilize after about 50 to 90 days; however, the degrees of this seen are benchmarks against which we have no comparison. Scars assessed after 1 year are favorable using both validated patient and observer related assessment tools.