Oral Presentation ANZBA Annual Scientific Meeting 2025

Clinical Audit of Biodegradable Temporising Matrix (BTM) Applications (2014 -2024) (22964)

Yue Min Crystal Phua 1 2 , Lindsay Shanks 3 , Hollie Moran 2 4 , Elizabeth S Concannon 5 6 , Nicholas Solanki 5 6 , Marcus JD Wagstaff 2 5 6
  1. Surgical Resident, Royal Adelaide Hospital, Adelaide, SA, Australia
  2. University of Adelaide Medical School, Adelaide, SA, Australia
  3. Burns Fellow, Royal Adelaide Hospital, Adelaide, SA, Australia
  4. Plastics and Burns Registrar, Royal Adelaide Hospital, Adelaide, SA, Australia
  5. Adult Burns Service, Royal Adelaide Hospital, Adelaide, SA, Australia
  6. Plastics and Reconstructive Surgery , Royal Adelaide Hospital, Adelaide, SA, Australia

In 2014, the institution treated its first burn patient with Biodegradable Temporising Matrix (BTM), a synthetic polyurethane bi-layered dermal substitute. Thereafter, five patients were involved in a single arm cohort study for burns injuries to validate BTM effectiveness (John E. Greenwood, 2018). We have since extended the use of BTM in other plastics cases, such as in necrotising fasciitis defects and traumatic wounds. As regulatory approval became established in the United States, Australia, New Zealand, the United Kingdom and beyond (Williams, 2023), BTM became a robust alternative for complex wound reconstruction.

The article presents unpublished data of the latest retrospective clinical case audit of a decade’s worth of experience with BTM application in burns and plastics in a single health network. 359 patients were identified through the Operating Room Management Information System. The patients’ data were then obtained using written notes and electronic medical records such as Sunrise and the Open Architecture Clinical Information System. Information such as demographics, length of stay, indication of BTM use, total body surface area coverage, anatomical site of BTM, mortality, and adverse outcomes were gathered. Complications, such as device infection rates, BTM removal and its replacements, were analysed and discussed.

Overall, the constellation of data reflects BTM use in the last 10 years. It depicts our learning curve across time, the development of our experience and techniques, and the adoption of nuances derived from discussions with other centres. This audit aims to highlight the improvements in BTM practice over the last decade and its challenges in the way ahead. In doing so, this paper shall enrich the conversation around BTM use and enable targeted quality improvements in its application and in patient outcomes. 

  1. Greenwood, JE, Bradley, JS, Wagstaff, MJD 2018, 'Experience with a synthetic bilayer Biodegradable Temporising Matrix in significant burn injury', Burns Open, vol. 2, no. 1, pp. 17-34.
  2. Williams, D., 2023, Chairman's and CEO's address to shareholders, ASX, [Online] viewed 2 June 2025.