ABSTRACT
Treatment of full skin thickness loss due to surgical debridement for difficult wound beds like necrotizing fasciitis and hidradenitis suppurativa (HS) is commonly treated using wide local excision and split-thickness-skin grafting or muscle flaps. Unfortunately, this strategy often leaves large soft tissue defects and can be complicated by infection and poor graft take, resulting in additional surgeries. Novel approaches using acellular dermal substitutes along with skin grafting are treatment options with favorable cosmetic outcomes and improve functionality by reducing contractures. However, patient non-compliance and various complications such as complex wound care, infection, product fragility and financial implications have contributed to a lack of widespread adaptation. NovoSorb Biodegradable Temporizing Matrix (BTMTM) has been demonstrated to function as a dermal scaffold that has robust handling characteristics and requires minimal wound care. This case report describes the treatment course of a high-risk patient with poor nutrition and a history of a 20 pack-year tobacco smoking, methamphetamine use, phencyclidine use, and marijuana use with recurrent and widespread axillary, inguinal, and gluteal HS. This patient was treated using NovoSorb BTMTM as the primary dermal substitute without subsequent grafting to cover a 400 cm2 left gluteal excision due to patient non-compliance. The covered area subsequently spontaneously epithelized after six months of local home health care during the COVID-19 pandemic. Our results show promise for future use of NovoSorb BTMTM to serve as a single stage surgery option to complete wound healing in high-risk patients. Copyright © 2022 The Authors
ABSTRACT
The paper presents the use of the collaborative learning approach when teaching the topic 'Design of Differentiators and Integrators in MATLAB' in the Course 'Digital Signal Processing' during the COVID-19 pandemic. Some issues about digital differentiators and integrators are described in the paper as well as the problems solved by students during the workshops and students' feedback about their satisfaction with this approach. © 2022 IEEE.
ABSTRACT
Objective This study aims to compare outcomes between Novosorb Biodegradable Temporizing Matrix (BTM) and Integra collagen-chondroitin silicone for upper-extremity wound reconstruction. Methods This retrospective study analyzed adult patients who underwent wound reconstruction with either BTM or Integra at our institution between 2015 and 2020. Results Forty-eight patients were included: 31 (64.6%) BTM and 17 (35.4%) Integra. Mean age was 44.0 (range: 18-68) years. Age, race, sex, smoking, comorbidities, and defect size were similar between groups. Wound etiologies included 12 (25.0%) burn, 22 (45.8%) trauma, and others. Median template size was 133 cm 2for BTM and 104 cm 2for Integra (p = 0.526). Skin grafting was performed after 14 (45.2%) and 14 (82.4%) wounds treated with BTM and Integra, respectively (p = 0.028). Template complications of infection and dehiscence were comparable. Skin-graft complications occurred in five (35.7%) and three (21.4%) wounds in BTM and Integra, respectively (p = 0.031). Skin-graft failure rates were comparable (p = 0.121). Mean number of secondary procedures required after template placement was higher in the Integra group (BTM, 1.0;Integra, 1.9;p = 0.090). Final healing was achieved in 17 (54.8%) BTM and 11 (64.7%) Integra wounds (p = 0.694). Median time to healing was 4.1 months after BTM and 2.6 months after Integra placement (p = 0.014). Conclusion Compared with Integra, BTM achieved comparable wound healing and complication rates. Fewer secondary procedures and skin grafts were observed in BTM wounds, likely as a result of the coronavirus disease 2019 pandemic. At our institution, 100 cm 2of product costs $850 for BTM and $3,150 for Integra, suggesting BTM as an economical alternative to fulfill the high functional and aesthetic requirements of upper-extremity wounds. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.