Showering with a Bone Tissue Matrix (BTM)
You should not shower with a Bone Tissue Matrix (BTM) until the wound has completely healed, typically 5-7 days after implantation, and then only with an impermeable cover to protect the site.
Understanding BTM and Wound Care
Bone Tissue Matrix (BTM) is a synthetic dermal substitute used in complex wound reconstruction. It consists of:
- A biodegradable polyurethane open-cell foam layer that induces cellular ingrowth
- A non-biodegradable silicone sealing membrane that protects the wound 1
Initial Healing Period (First 5-7 Days)
- Keep the BTM site completely dry until wound healing is complete 2
- No showering during this initial period to prevent infection and matrix disruption
- Follow your healthcare provider's specific instructions for wound care
Showering Protocol After Initial Healing
Once the initial healing period has passed (typically 5-7 days):
Use waterproof protection:
- Apply an impermeable cover over the BTM site before showering 2
- Ensure complete coverage of the wound area
Showering technique:
- Keep showers brief
- Use lukewarm water (not hot)
- Direct water away from the BTM site when possible
- Never submerge the BTM site in water (no baths, swimming pools, or hot tubs) 2
Post-shower care:
- If the site accidentally gets wet, clean and disinfect properly 2
- Gently pat dry with a clean towel
- Apply any prescribed dressings or medications
Special Considerations
Infection Prevention
- BTM is resistant to infection due to its synthetic composition 3, but proper wound care remains essential
- Monitor for signs of infection: increased redness, warmth, swelling, discharge, or pain
- Indoor showerheads are a known source of nontuberculous mycobacteria (NTM) 4, which could potentially contaminate healing wounds
BTM Applications and Care
- BTM is used in various complex reconstructions including burns, traumatic wounds, and exposed bone/tendon cases 3, 5
- The care protocol may vary depending on the location and size of the BTM application
- Larger BTM applications (average size 162.5 cm²) may require more careful protection 5
When to Contact Your Healthcare Provider
Contact your healthcare provider immediately if you notice:
- Signs of infection
- Fluid collection under or around the BTM
- Template dehiscence (separation of the BTM from the wound bed)
- Increased pain or discomfort
Long-term Care
For optimal outcomes with BTM:
- Continue to protect the site during showering until complete healing
- Follow your surgeon's specific instructions regarding the timing for the second stage procedure (if applicable)
- Some BTM applications may eventually be skin-grafted while others may heal secondarily 3
Remember that proper wound care significantly impacts the success of BTM integration and overall healing outcomes.