Assessing the Impact of Number of Surgical Staples Per Square Centimeter Used in Biodegradable Temporizing Matrix (BTM) Application on Burn Patient Outcomes

Severe burns involve the full thickness of the skin and subcutaneous structures. These burns require skin grafting, and the primary type of skin graft used is a split-thickness skin graft (STSG) coupled with dermal substitutes. However, due to certain complications with this type of graft, artificial skin substitutes have gained traction as an alternative to autologous skin grafting. Biodegradable temporizing matrix (BTM) is an example of a dermal regenerative matrix. Biodegradable temporizing matrix grafting is secured with surgical staples. The study aim is to assess the association between the number of staples per square centimeter used to secure this graft on patient outcomes. This single-center, retrospective study analyzed 39 patients who received BTM grafting between 2017 and 2024. Primary outcomes included graft take, hospital stay, and time to grafting. Statistical analyses included linear, logistic, and Poisson regression, adjusting for confounders like diabetes and wound infection. Increased staple density significantly reduced hospital stay and trended toward shorter time to STSG, improved graft take, and fewer grafting surgeries. Results indicate a potential role for staple density in optimizing outcomes. Limitations include small sample size, single-institution design, and possible measurement errors in staple counting. Future research should focus on larger, multicenter studies and standardized staple counting methods to validate these findings.