Poster Presentation New Zealand Association of Plastic Surgeons Annual Scientific Meeting

The use of radiotherapy on Biological Temporising Matrix for immediate reconstruction, a retrospective cross-sectional study. (1667)

Chelsea Allen-Brough 1 , Toby Ball 1 , Eric Tan 1
  1. Department of Plastic and Reconstructive Surgery, Waikato Hospital, Hamilton, New Zealand

Background: Biodegradable Temporising Matrix (BTM) has become an essential resource in soft tissue reconstruction in many plastics units, since its introduction to the market in 2016.(1-3) Providing a safe and relatively simple coverage option for soft tissue defects secondary to burns/trauma/infections/malignancy. However the effect of radiotherapy to BTM remains relatively un-studied, we aimed to investigate its impact.


Methods: A retrospective cross-sectional study was used to review plastics patients who received radiotherapy to BTM. We reviewed elective theatre bookings from 1st January 2020 to 31st December 2023 for mention of either BTM or free flap reconstruction. We included those who had BTM applied during surgery and who had radiotherapy given to the BTM site. Reported outcomes for those included were BTM integration, BTM wound site infections and returns to theatre

Results: 201 elective bookings with either BTM or free flap were identified, we excluded 25 as no BTM was used and 28 as duplicate entries for patients who had multiple procedures. 148 patients had BTM applied, 19 (12.8%) received radiation to the BTM. Of those patients all 19 (100%) were reconstructed for a cutaneous malignancy, had a mean age of 75.3years, were 78.9% NZ European and had BTM applied to head/neck 78.9% and upper limb 21.1%. 3 (15.8%) had their BTM delaminated and a split thickness skin graft applied. They received on average 49.8 Gray in 20.2 fractions of radiotherapy within the first 90 days (mean 78.9days) following BTM application. They experienced 8 (42.1%) complications compared to 15 (11.6%) in those who did not receive radiation (p=0.350).

Conclusion: Immediate radiotherapy treatment of wounds reconstructed with BTM, does not appear to significantly increase rates of BTM complications in this patient group. Supporting the role of early progression to adjuvant radiotherapy in those with BTM reconstruction of malignancy related soft tissue defects.

  1. 1. Brennan, P. (2016, October 10). Australia and New Zealand Distribution Agreement – PolyNovo – BTM. Linkedin. Retrieved April 27, 2024, from https://www.linkedin.com/pulse/australia-new-zealand-distribution-agreement-btm-paul-brennan
  2. 2. K. Crowley, S. Balaji, H. Stalewski, D. Carroll, B. Mariyappa-Rathnamma. Use of Biodegradable Temporizing Matrix (BTM) in large trauma induced soft tissue injury: A two stage repair, Journal of Pediatric Surgery Case Reports, Volume 63, 2020, 101652. ISSN 2213-5766. https://doi.org/10.1016/j.epsc.2020.101652. https://www.sciencedirect.com/science/article/pii/S2213576620302864)
  3. 3. John E. Greenwood, Bradley J. Schmitt, Marcus J.D. Wagstaff. Experience with a synthetic bilayer Biodegradable Temporising Matrix in significant burn injury, Burns Open, Volume 2, Issue 1, 2018, Pages 17-34. ISSN 2468-9122. https://doi.org/10.1016/j.burnso.2017.08.001. (https://www.sciencedirect.com/science/article/pii/S2468912217300378)