Biodegradable Temporizing Matrix in Postoncological Scalp Reconstruction: A Case Series

Biodegradable temporizing matrix (BTM) is a synthetic biodegradable dermal matrix that helps develop a non-skin graft amenable wound bed (eg, over tendon or bone) into a graftable wound bed, by acting as an inert scaffold for angiogenesis and formation of granulation tissue. There is currently a paucity of evidence to encourage its use in scalp defects following skin malignancy excision. This retrospective analysis aimed to evaluate the utility of BTM in this patient subset. This is a case series of patients undergoing BTM reconstruction for scalp defects following skin malignancy excision between January 2022 and January 2024. Data collected included demographics, as well as oncological and reconstructive outcomes. Thirteen distinct BTM cases were identified in 12 patients. All patients were male with a median age of 85 years. Of 13 lesions, 10 were confirmed squamous cell carcinoma, with 3 confirmed as malignant melanoma. Of 13 cases, 12 required excision down to the calvaria, with 1 down to pericranium. Of 13 cases, 11 went on to receive a split-thickness skin graft (STSG) after BTM application, with a median interval of 46 days. All these patients had complete take of their subsequent STSG. Two cases did not receive STSG, 1 had satisfactorily healed upon delamination of the BTM, and 1 had failure of BTM due to bacterial colonization. This study demonstrates the utility of BTM as a successful, low morbidity reconstructive option in patients undergoing skin cancer excision on the scalp.