Biodegradable Temporizing Matrix reconstruction of complex perineal burn wound: A Case Report.

This case report details our experience using two-stage Biodegradable Temporizing Matrix (NovoSorb® PolyNovo Ltd) and autograft for acute reconstruction of a complex perineal burn wound in an elderly co-morbid patient. A 77-year old man sustained 42% full thickness burns extending circumferentially from bilateral thighs and buttocks, across the entire perineal and genital regions up to his mid-trunk, following self-immolation using an accelerant. Early total burn wound excision was carried out with acute application of Biodegradable Temporizing Matrix to all affected sites. Excellent integration and vascularisation of Biodegradable Temporizing Matrix took place despite the challenge of intermittent faecal contamination affecting the perineal and buttock burn sites and matrix colonisation with multi-drug resistant organisms. Delamination and serial split thickness skin autografting was carried out 42 days after first matrix application with complete and robust graft take. Perineal burns present a reconstructive challenge due to the proximity of specialised structures such as the genitalia, urethral and anal orifices. Restoration of complex anatomy and function may be required after debridement with increased risks of infection, contracture formation and mortality compared with burns affecting other anatomical sites.Two-stage Biodegradable Temporizing Matrix represents a reliable reconstruction option for complex extensive perineal wounds in frail elderly patients, despite an unfavourable local microbial environment.