Background:
Cutaneous malignancy reconstruction can vary in complexity, from direct closure to free flap reconstruction. Biodegradable Dermal Matrix (BTM) reconstruction of defects from trauma and necrotising fasciitis is well described in literature. Outcomes following reconstruction of cutaneous malignancy defects are not well known.
Methods:
We report two interesting cases of cutaneous malignancy reconstruction referred to our specialist tertiary cancer centre in 2022. A review of the recent literature was performed.
Case 1:
A 73-year-old female presented with a large, radially expanding and focally ulcerated, infiltrating, sclerosing and nodular basal cell carcinoma (BCC) extending over the patient’s forehead, left upper eyelid, nasal bridge, and right medial canthus. Wide local excision (WLE) was initially performed as a DRAPE procedure (delayed reconstruction after pathological examination). Further resection was performed with BTM reconstruction, later followed by delamination and skin grafting. At 8 weeks post reconstruction, good functional and cosmetic outcomes were achieved.
Case 2:
An 84-year-old female presented with a large Marjolin ulcer (squamous cell carcinoma) affecting the tissues over her right tibia and Achilles tendon. WLE to periosteum and tendon left a non-graftable defect, so reconstruction was performed with BTM. An extended period of BTM integration was required; delamination and split skin graft reconstruction occurred at approximately 8 weeks post operatively. At 8 weeks post reconstruction, good cosmetic and functional outcomes were achieved.
Conclusion:
BTM offers a viable alternative for patients who would otherwise require more complex reconstruction via free flap reconstruction, providing a cosmetically and functionally acceptable outcomes.