Background: Non-graftable and composite wound defects present major challenges to the reconstructive surgeon. Many defects require complex local flap or free microvascular tissue transfer (free flap) approaches. Synthetic skin substitutes including Biodegradable Temporising Matrix (BTM) have revolutionised the management of these complex defects with low-morbidity and low-complexity surgery. However, limited data exist for their use in cancer reconstruction in Australia.
Methods: A retrospective review was performed of all patients undergoing cancer resection and BTM reconstruction between February 2021 and August 2022 in our institution. Outcomes included BTM integration, postoperative infection, and return(s) to theatre.
Results: Twelve patients were treated for primary or secondary defects following cancer resection during this period. Eight patients were male, four female, mean age at surgery was 68 years. Surgical defects included squamous cell carcinoma (SCC) and melanoma of the scalp, face, lower limb, and SCC-related osteoradionecrosis (ORN) of the scalp. T-stage of primary tumours ranged from T2 to T4. There was one case of in-transit melanoma metastasis. Four patients were treated with post-operative radiotherapy. Overall BTM integration was 83% (10/12), with a 50% integration rate (2/4) observed in the post-radiotherapy group. Failed integration required return to theatre for alternative reconstructive approaches.
Conclusion: We report our experience with BTM reconstruction for complex cancer-related tissue defects in 12 patients, the largest cohort of this type in the Australian literature. BTM represents an exciting reconstructive tool for the cancer reconstructive surgeon, with a high rate of successful integration and low morbidity.