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Title: The Use of BTM for Free Flap Donor Sites to reduce Rates of Donor Site Morbidity


Authors: Dr. Lorcan Lawlor 1, Mr. Fiachra Martin 1, Mr. Gary Fenn 1
Publication: Journal of The Irish Head and Neck Society - 2025
Issue: 3 Volume: 3
Published: February, 2025 View PDF

Background:
BTM is a novel synthetic dermal matrix made from a polyurethane foam and has been to aid the healing in complex wounds, burns and free flap donor sites. Wagstaff et al. 2 have previously shown that BTM can improve the long-term outcome of scarring in free flap donor sites. The donor sites for these free flap reconstructions can often result in significant morbidity for patients. Due to reports in the literature of the benefits that the application of BTM to these donor sites at the time of initial reconstruction can have we have trialled this in our practice. Our main goal was to assess whether there is a reduction in morbidity for patients who are treated with BTM as opposed to patients who receive a skin graft on the date of reconstruction.

Methods:

Retrospective Cohort looking out outcomes of patients who had BTM applied to the free flap donor site during microvascular reconstruction. Outcomes were assessed by recording morbidity rates looking specifically at rates of radial nerve palsy, tendon exposure and graft failure.

Results:
10 Patients in total. There were 8 patients who had a Radial Forearm and the other two patients had an ALT free flap. Our results have shown no cases of Radial Nerve Palsy, excellent rates of skin graft take.

Conclusions:
BTM can be used as an adjunct in complex free flap reconstruction cases as a method of reducing donor site morbidity and therefor improving patient experience and outcomes

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