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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.035 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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 source (direct Gemma or distilled Codex), 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".