Case Study. Effectiveness of Collagen-elastin Matrix in Reconstructive Burn Surgery: A Case Study

Abstract Patient Presentation (age range, injury details, relevant history) A 33-year-old male sustained 31% total body surface area (TBSA) burns during a grain silo explosion. Clinical Challenges His clinical course was complicated by wound infections with environmental organisms uncommon in routine burn care. Rehabilitation was further limited by non-compliance with outpatient therapy, splinting, and follow-up. He subsequently developed a severe recurrent antecubital fossa contracture of the right upper extremity that restricted elbow extension and functional independence. Management Approach The patient underwent admission for definitive management. After wide excision of hypertrophic scar tissue, a 1 mm-CEM as well as split-thickness skin graft (STSG, 0.008 inches) were applied over the defect and secured using negative pressure wound therapy (NPWT) at -75 mmHg. NPWT was continued for an additional 11 days. Early physiotherapy was re-initiated on postoperative day (POD) 9. Outcomes Preoperatively, elbow extension was limited to 55°, measured by outpatient facility utilizing goniometry. Full extension to 0° was achieved intraoperatively and preserved through POD 9. At graft takedown, 100% graft adherence was noted, without loss or complications. The patient was discharged on POD 21 with instructions for strict adherence to therapy. At 2 months, elbow extension measured 0° and has remained stable at follow-up to date. Lessons Learned This case highlights the effectiveness of CEM in reconstructive burn surgery, allowing early grafting, durable functional correction, and shortened hospitalization. With improved adherence to rehabilitation, the patient regained meaningful upper-extremity function after three years of disability. Applicability to Practice The use of CEM may change reconstructive burn protocols by accelerating time to graft readiness, reducing morbidity, and improving functional outcomes in high-risk patients, including those with infection, recurrence, or compliance challenges.