Perfusion-guided use of a lactide-based terpolymer dermal matrix in deep dermal burns

Background Deep dermal burns remain a therapeutic challenge, requiring treatment strategies that promote healing while minimizing surgical burden and scarring. Synthetic dermal substitutes based on polylactide terpolymers may offer a promising option for managing deep dermal burns. This study evaluated the clinical value of a polylactic acid (PLA)-based matrix (SupraSDRM®, PolyMedics Innovations GmbH) in deep dermal burns using objective perfusion assessment with Laser Doppler Imaging (LDI). Methods An analysis was performed in 10 consecutive patients with acute thermal burns treated with PLA. Burn depth was assessed preoperatively using LDI. Demographic and burn-related data, timing of matrix application, pain intensity (Numeric Rating Scale, NRS), need for secondary split-thickness skin grafting, length of stay, and scar quality (Vancouver Scar Scale, VSS) were analyzed. Results Mean patient age was 42.3 years (range 16–66) and mean TBSA was 7.5% (range 0.3–18%). The matrix was applied on mean post-burn day 4. Pain intensity decreased significantly from a mean NRS of 5.8 before intervention to 1.8 at 24 h after application ( p = 0.002). Mean hospital stay after matrix application was 6 days. Definitive wound healing without grafting was achieved in 8/10 patients. Two patients (6 and 7) required secondary grafting after wound infection that developed following matrix application. At follow-up, scar quality was favorable (mean VSS: 3.3). Scar quality was assessed at the latest available follow-up visit, with a mean follow-up of 12 months (range 8–18). Conclusion Within a perfusion-guided treatment algorithm, lactide-based terpolymer dermal matrices may enable early pain reduction and graft-free wound healing in selected deep dermal burns. When grafting is required, they may still be applied as part of wound bed preparation prior to grafting, supporting their role as a bridge-to-healing strategy.