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Biodegradable Temporizing Matrix in Postoncological Scalp Reconstruction: A Case Series
Tom Calderbank1, Emma Turner1, Mohaned Mohamed1
1From the Department of Plastic Surgery, Hull University Teaching Hospitals, East Riding of Yorkshire, United Kingdom.
Plastic and Reconstructive Surgery. Global Open
|January 29, 2025
Summary
Biodegradable temporizing matrix (BTM) is effective for scalp defects after skin cancer removal. This synthetic matrix promotes healing and successful skin grafting, offering a low-morbidity reconstructive option.
Area of Science:
- Dermatology
- Plastic Surgery
- Wound Healing
Background:
- Scalp defects after skin cancer excision pose reconstructive challenges.
- Limited evidence exists for using biodegradable temporizing matrix (BTM) in these specific defects.
- This study evaluates BTM's utility in creating a graftable wound bed for scalp reconstruction.
Observation:
- A case series of 13 BTM applications in 12 male patients (median age 85) with scalp defects post-skin malignancy excision (10 squamous cell carcinoma, 3 malignant melanoma).
- Most defects (12/13) extended to the calvaria, requiring significant reconstruction.
- 11 patients received split-thickness skin grafts (STSG) after BTM application (median 46 days), with complete graft take in all cases.
Findings:
- Biodegradable temporizing matrix (BTM) facilitated successful split-thickness skin grafting in 11 out of 13 scalp defect cases.
- One case healed satisfactorily after BTM removal without grafting.
- One case experienced BTM failure due to bacterial colonization, highlighting a potential complication.
Implications:
- BTM is a viable, low-morbidity option for reconstructing scalp defects after skin cancer excision.
- It effectively prepares challenging wound beds, such as those down to the calvaria, for subsequent skin grafting.
- Further research could explore strategies to mitigate complications like bacterial colonization.
