634 Biodegradable Temporising Dermal Matrix Graft for Open Foot Wounds, an Audit from a Tertiary Vascular Unit

Abstract Aim Following diabetic foot attacks many patients are left with exposed bone, which can lead to osteomyelitis and failure to heal. These patients are currently treated with simple dressings or vacuum therapy and skin grafts. However, vacuum therapy is expensive, requires intensive follow-up and can be inconvenient to patients. An alternative is to apply a polyurethane-based, biodegradable temporising matrix – currently used in burns practice. The aim of this project was to audit the safety and preliminary efficacy of the matrix in healing open foot wounds in a tertiary vascular unit. Method Consecutive patients receiving matrix cover from January 2021 were retrieved from the theatre database. 10 patients met our inclusion criteria, 5 males and 5 female patients with a mean age of 69 years. Five (50%) were diabetic, 10% were smokers and 40% were ex-smokers. Two patients died prior to wound healing and one patient was lost to follow-up leaving 7 patients. Results Safety: One patient developed surgical site infection, managed with wound washout and dressing changes with no loss of matrix. No patient developed osteomyelitis. Efficacy: Wound healing occured in 5 patients, after a median of 51 days (IQR 12 days). One patient underwent an additional skin graft on top of the matrix and healed. One patient did not heal. Conclusions In this early report we found a low rate of matrix infection or requirement for skin grafting. Two-thirds of wounds healed following matrix application. A comparative study of matrix vs vacuum therapy would be valuable.