The use of an acellular wound matrix for Mohs surgical reconstruction: a case series

Malignancies of the foot are relatively rare and pose a problem for clinicians, with malignant melanoma in this area associated with poor prognosis. The foot has unique anatomy for weight bearing, and preserving this role is imperative; as such, smaller-than-recommended margins are often taken to preserve patient function.

To evaluate the effectiveness of an acellular wound matrix for soft tissue reconstruction after Mohs surgical resection of soft tissue lesions in the foot.

The records of 29 patients who underwent a Mohs surgical procedure from January 2018 to January 2023 were reviewed. The same surgeon performed all these surgeries. The average healing time, wound size, and complication rates were noted.

The average patient age was 61.3 years. Twelve of the subjects were male (41.4%) and 17 were female (58.6%). Nineteen (65.5%) of the lesions were diagnosed as melanoma, and 10 lesions (34.5%) were located on the toe. The average wound size after surgical resection was 4.4 cm × 4.0 cm × 0.8 cm. Twenty-two patients healed (75.9%). The average (SD) wound healing time was 139 (90.8) days. Eight patients (27.6%) had postoperative complications.

Using an acellular wound matrix after Mohs surgical resection of soft tissue lesions in the foot is a viable option. Patients functioned well after healing. Complication rates are higher in the foot than in other areas of the body using this protocol. Good surgical technique and strong knowledge of the anatomy of the foot and ankle are needed to prevent and manage these complications.