PolyNovo
The Foundation To Successful Dermal Reconstruction

When Novosorb® BTM (Biodegradable Temporizing Matrix) was introduced to the world as a polyurethane polymer, a new standard for skin and wound care was established by PolyNovo. The company introduced a polymer that could not only coexist with cells of the human body when applied to a fully depleted wound bed but also catalyze the production of collagen necessary for wound healing. The polymer dissolves in the body with the development of connective tissues that eventually replace the NovoSorb BTM as a new dermal layer. Essentially developed as a dermal substitute, Novosorb BTM soon opened the doors to numerous biodegradable synthetic medical devices.

"In the absence of dermis, which forms the structure and foundation of the skin, NovoSorb BTM is applied onto a wound, and the tissues of the body grow into it as the NovoSorb BTM slowly biodegrades, serving as the foundation for reconstruction," explains Dr. Marcus Wagstaff, chief medical advisor, PolyNovo. Cementing this value proposition, Novosorb BTM evolved into a foundational technology that features remarkable clinical outcomes beyond conventional modalities of care today.

When a person is inflicted with significant trauma to the skin, they lose far more than the skin itself. They could experience renal failure, lung injury, sepsis, or worse, organ failure. Closing these wounds is essential for the patient to survive and the current standard is through skin grafting, the harvest of a thin layer of a patient’s own skin to cover and eventually close the wound. However, when all layers of the skin have been compromised, skin grafting may not be an immediate viable option. NovoSorb BTM improves clinical efficacies by creating win-win situations, whereby the grafting procedure can be delayed until the patient is healthier and organs have recovered. At the same time, the temporizer serves as the substrate for reconstruction, resulting in a smoother and more durable structure of the dermis. By virtue of hydrolysis, NovoSorb BTM eventually gets excreted through urine, mitigating long term adversities for patients from the dermal scaffold procedure.

The polymer's synthetic and inert chemical characteristics push the boundaries of what a dermal substitute could achieve. Contrary to biological dermal substitutes, which could get digested by bacteria, NovoSorb BTM is invaluable for wounds that become contaminated, rarely necessitating device removal while the contamination is managed. Likewise, the polymer has also found applicability in reconstructing wounds from flesh-eating
bacteria, which is a severe and potentially life-threatening infection; once the infection is under control, clinicians use NovoSorb BTM to reconstruct the wound and eventually close the patient.

NovoSorb BTM is also used to treat hidradenitis suppurativa, another challenging and hostile wound environment, in addition to treating soft tissue injuries such as road accidents. It also helps aged patients with vascular diseases who cannot sustain complex soft tissue reconstruction procedures. In some cases, NovoSorb BTM eliminates the need for amputations when most options cease to exist for severely injured individuals.



One of the most critical but understated benefits of NovoSorb BTM is the treatment methodology it follows. When stabilizing a patient, infection control can play a decisive role in the patient's speedy recovery. Most severe wounds are produced in filthy environments, increasing the infection probability. Owing to this care-intensive procedure, biologic dermal substitutes may require several applications, further destabilizing the patient and prolonging the journey to recovery. Contrary to this practice, NovoSorb BTM is designed to be sutured or stapled on top of a wound without additional applications. In the healing process, the body produces blood vessels and fibroblasts that divide and spread across the affected area and the temporizing matrix.

The biocompatibility and the inert nature of the synthetic polymer makes sure that it is the patient that integrates the NovoSorb BTM and not the other way around

"When collagen is layered on a wound bed as sheets through traditional biologics, the wounds are prone to be ruptured due to inherent stiffness when the skin stretches. The problem is further aggravated with joints that could stiffen up or limit movements of the body part entirely," explains Dr. Wagstaff. "With the NovoSorb BTM layer in place, collagen produced by the body breeds in the form of a circle, contained with the NovoSorb BTM, effectively shortening and shrinking the wound. PolyNovo’s NovoSorb BTM is designed to avoid the shrinkage of the skin, which could cause abnormalities such as stiffening of joints and undesired contouring of wounds. NovoSorb BTM's microarchitecture converts a large macro wound into a series of small microwounds, interconnected to support cellular migration in an organized fashion for improved patient outcomes.

Eventually, when the skin graft procedure is considered, NovoSorb BTM is designed to help reduce contracture with the intent of improving cosmesis and functional outcomes, providing the patient greater freedom to move. The synthetic chemistry of NovoSorb BTM allows the device to stay resilient in the face of infection; the matrix does not get digested by bacteria, unlike traditional biologics that May offer no resistance to bacterial spread.

"The biocompatibility and the inert nature of the synthetic polymer make sure that it is the patient that integrates the NovoSorb BTM and not the other way around," adds Dr. Wagstaff. "In this simplicity, there also lies elegance."

Ten years ago, medical professionals often hesitated using a dermal substitute for the uncertainties it brings into an operational setting. Circumstances as ordinary as an injured diabetic foot would invariably present these professionals with an ardous challenge in reconstructing wounds. Dr. Wagstaff recalls testing situations in which clinicians would have to compromise a patient's return to everyday life, fearing the possibility of infections caused by traditional biologics, risk of amputation due to the severity of the injury, or even controlling the aesthetical changes brought forth by a reconstruction procedure. Addressing many such use cases, PolyNovo, in association with experts such as Dr. Wagstaff, has demonstrated multiple times the clinical efficacies derived from the NovoSorb BTM. In some cases, patients with life-threatening injuries, immobilized or carrying the risk of amputation, have recovered and are leading a life of normalcy. The ease of applicability and wound management also provides a clearer pathway to therapeutic wellness, allowing clinicians to plan the course of treatment with lesser uncertainty. This merit proves essential for practitioners as they scale the reconstructive ladder for different choices in therapeutic procedures; PolyNovo's solutions simplify those
choices while mitigating any possible pitfalls in remediation.

"In the 30 years of my career, I, along with others, have introduced much innovation. But invariably, such innovation comes with added cost and complexity and teaching the surgeon how to do things differently," explains Swami Raote, CEO of PolyNovo. "For the first time, I see this innovation is breathtakingly simple in its design, enabling the body to enhance its own healing process."

From a patient standpoint, NovoSorb BTM does a lot more than save lives; it offers them a new chance at life by bringing to the fore technological solutions that are simple and effective alternatives to traditional modalities. PolyNovo achieves this through a solution that does not burn a hole in the client's pocket but instead presents a faster pathway to recovery inexpensively.