Sternotomy through anterior chest wall burns temporised with an implanted synthetic dermal matrix

Abstract

Large burns generate significant hypermetabolic and inflammatory responses which increase cardiovascular complications in animal models. A 70 year old male (Fig. 1a) presented with 20% total body surface area flame burns, involving his anterior chest wall. His burn wounds were debrided and temporised with a dermal substitute [NovoSorb® Biodegradable Temporising Matrix (BTM)]. His post-operative course was complicated by acute coronary syndrome requiring coronary artery bypass grafting via sternotomy through the BTM integrating into the chest wall wounds. The patient proceeded to complete BTM integration despite the sternotomy incision carried out through it, with excellent graft take and uncomplicated healing. We describe a previously unreported application of BTM for burn wound reconstruction using a technique that facilitated a surgical incision to carry out open cardiac surgery without compromising wound healing.

Keywords

• Burn
• Full thickness
• BTM
• Biodegradable Temporizing Matrix
• Novosorb
• Sternotomy