Introduction: NovoSorb MTX is a fully synthetic, biodegradable polyurethane matrix similar to BTM but without a sealing membrane.[2]There are currently no published case reports describing its use in acute burn reconstruction. Case: A 72 years old man presented with flame burns to both hands and lower limbs after his clothing caught fire. His medical history included nephrectomy for renal cell carcinoma, hypertension, gout, and type 2 diabetes mellitus. Examination revealed a full-thickness burn over the left popliteal fossa with surrounding partial-thickness injury, and dermal burns to the right thigh, knee, and both hands. Following initial wound care and referral to the burns service, he underwent tangential excision of the full-thickness burn on day five post-injury. MTX was applied and secured with staples, covered with antimicrobial dressings, and immobilised. Other burn wounds were debrided and dressed. At 18 days, the MTX demonstrated good integration, and STSG from the ipsilateral thigh was meshed and secured to the wound bed. Approximately 95% graft take was observed at five days. Discussion: Although BTM has established efficacy in burn reconstruction, data on MTX remain limited. The absence of a sealing membrane removes the need for delamination and may improve conformability and contact in anatomically challenging and mobile areas. Conclusion: At 10-week follow-up, all wounds were fully healed with no joint contracture or significant scarring. This case suggests MTX is a promising dermal substitute for burn reconstruction over mobile joints, with excellent graft take and functional outcomes. References: 1.Greenwood, J. E, et. al. (2018). Experience with a synthetic bilayer Biodegradable Temporising Matrix in significant burn injury. Burns Open : An International Open Access Journal for Burn Injuries, 2(1), 17–34. https://doi.org/10.1016/j.burnso.2017.08.001 2.PolyNovo, ‘ASX announcement’ NovoSorb MTX product portfolio update (Announcement, 19 March 2025)