The Metabolic Impact of Biodegradable Temporizing Matrix in Burn Patients: A Retrospective Analysis of Resting Energy Expenditure and Inflammation.

Severe burn injuries induce a hypermetabolic state, significantly increasing resting energy expenditure (REE) and systemic inflammation, which can impact wound healing and patient recovery. Biodegradable Temporizing Matrix (BTM), a synthetic polyurethane dermal substitute, has been increasingly used for large total body surface area (TBSA) burns, yet its metabolic effects remain unclear. This retrospective cohort study analyzed burn patients from 2013-2022 who underwent metabolic cart measurements following excision and wound coverage with autograft, allograft, or BTM. Mixed-effects linear regression modeling was performed to assess the impact of wound coverage type on REE and C-reactive protein (CRP) levels over time. Among 226 patients, those receiving BTM had significantly higher REE (+403.5 kcal, p<0.05) compared to allograft when considering all time points. However, when restricting analysis to 2-8 weeks post-excision, REE differences were not significant, while CRP levels were significantly lower in the BTM (-3.07 mg/dL, p=0.0388) and autograft (-3.32 mg/dL, p=0.0107) groups relative to allograft. These findings suggest that BTM use is associated with increased metabolic activity but a reduced inflammatory response over time. The observed differences in metabolic and inflammatory profiles provide insight into the biologic impact of BTM and support further investigation into its role in optimizing burn wound management and recovery.