Integra® versus Novosorb® biodegradable temporizing matrix for burn wounds: a comparative systematic review and meta analysis
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Integra® is a bovine-derived artificial dermal matrix (ADM) widely used in the management of burns. More recently, Novosorb® Biodegradable Temporizing Matrix (BTM) has emerged as a fully synthetic ADM product. While experience with Integra® and BTM has been separately reviewed, burn wound healing outcomes and infectious complications have yet to be pooled and compared. METHODS: Following librarian-reviewed systematic search, a mixed-effects meta-regression model was fitted based on all studies with ADM type as a categorical moderator. A two-stage individual patient data (IPD) meta-analysis was also conducted. RESULTS: Thirty-five studies were included, the majority of which were non-comparative case series. Nineteen studies provided IPD. 674 patients were treated with Integra® and 288 with BTM. Integration time prior to second stage skin grafting was significantly longer with BTM than Integra® (32.11 vs 18.4 days, p < 0.01). Skin graft take was higher with BTM than Integra® when effects of NPWT use, template size and patient age were adjusted on meta-regression (90.6 vs 77.2 %, p = 0.016). This remained significant on two-stage IPD meta-analysis and exclusion of studies with high risk of bias. Moderator-adjusted infection rate was higher with BTM than Integra® (22.8 vs 2.96 %, p = 0.0072), but no differences were observed in average template take or infection-related reoperation rate. Wound closure rate, defined as > 95 % wound epithelialization, was comparable with BTM and Integra® (96.0 vs 96.5 %, p = 0.81). DISCUSSION: While acknowledging BTM's prolonged healing timeline with no difference in overall wound closure rate, BTM may offer improved graft take and greater salvageability than Integra® in the event of infection. SUMMARY AND CONCLUSION: Very low-quality evidence suggests that BTM is associated with longer integration time and higher graft take when compared to Integra®. Infection rate was higher with BTM than Integra® but there was no difference in template take or need for reoperation. Overall wound closure rates were comparable.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".