The Role and Efficacy of NovoSorb Biodegradable Temporizing Matrix in Complex Reconstructive Wounds: A Systematic Review

Background: Managing complex wounds with exposed bone, tendons, metalware, or irradiated tissue is challenging. NovoSorb Biodegradable Temporizing Matrix (BTM) offers an alternative by promoting vascularization and neodermis formation. This review assessed the effectiveness of BTM in managing complex wounds, including those with vascular compromise (eg, periosteal stripping or denuded paratenon) or exposure to radiotherapy. Methods: A systematic search of Embase, Ovid, Scopus, and PubMed was conducted. Inclusion criteria included wounds involving exposed bone, tendons, or radiotherapy exposure. Data were analyzed for clinical outcomes, demographic variables, and complications. Results: A total of 208 patients across 34 studies were analyzed. The overall complication rate was 27.9%. Wounds with combined bone and tendon exposure and periosteal stripping or denuded paratenon had significantly higher complication rates than those with only exposed bone and tendon (57.1% versus 35.3%, P = 0.006). Denuded tendons only had significantly higher complication rates compared with intact tendons (38.9% versus 18.6%, P = 0.044). Across all wounds, the presence of periosteal stripping and/or denuded paratenon was linked to significantly more complications (40.0% versus 21.8%, P = 0.005). Chronic wounds were independently associated with a 4-fold increase in complication risk ( P = 0.013). Upper extremity wounds had significantly lower complication rates than lower extremity wounds (odds ratio 0.295, P = 0.008). Increasing age was independently associated with poorer outcomes (odds ratio 1.015 per year, P = 0.039). Conclusions: BTM is a valuable addition to the reconstructive armamentarium. However, complication rates in complex wounds are high, so careful clinical judgment is essential for their implementation.