Clinical Impact of Biodegradable Temporizing Matrix Implant in Accelerating Wound Healing and Minimizing Complications: A Retrospective Observational Study

Abstract

Background: Lower-limb soft-tissue defects with exposed bone or tendon remain difficult to reconstruct, and synthetic dermal matrices such as BTM may offer improved early wound stability and functional outcomes compared with conventional care.

Objectives: To determine the outcomes among BTM implant management techniques in terms of wound healing rate, complication rates, graft or implant survival, restoration of tissue integrity, and patient satisfaction.

Methods: We conducted a single-centre, hospital-based retrospective comparative study at the Department of General Surgery, Chettinad Hospital and Research Institute, Chettinad Academy ofResearch and Education, Kelambakkam - 603103, Tamil Nadu, India. (January 2024–June 2025; IHEC approved reference number-II/0937/25 dated 05.09.2025) including 30 patients ≤65 years with perfused lower-limb soft-tissue defects managed with either BTM (n=15) or conventional care (STSG/NPWT/dressings; n=15)

Results: Baseline parameters including age, BMI, defect duration, wound size, comorbidities, etiologies, and location (foot 43%, ankle 30%). Distal perfusion was adequate in all, and laboratory indices – including haemoglobin (12.5 g/dL), creatinine (0.9 mg/dL), liver enzymes, albumin (3.5–3.6 g/dL), coagulation, and glucose – did not differ. Intraoperatively, BTM showed numerically shorter operative time (72.4 vs 78.6 min; p=0.388) and lower blood loss (95 vs 120 mL; p=0.248). Early postoperative events trended lower with BTM, and the composite ‘any complication’ was significantly reduced (33.3% vs 60.0%; p=0.039). At two weeks, BTM outperformed conventional care; complete wound healing (60.0% vs 26.7%; p=0.021), graft/implant integration (86.7% vs 66.7%; p=0.042), and independent ambulation (66.7% vs 40.0%; p=0.032) were higher. Patient-reported outcomes favoured BTM (good/very good cosmetic results 80.0% vs 53.3%, p=0.025; satisfaction 86.7% vs 60.0%, p=0.020). Range of motion was numerically higher but not significant. Length of stay (6.4 vs 7.8 days; p=0.012) and return to work (23.1 vs 28.4 days; p=0.027).

Conclusion: BTM achieved superior early wound healing and integration with fewer complications, better functional and patient-reported outcomes, and shorter hospital stay than conventional management in perfused lower-limb defects.