DS26 Biodegradable Temporising Matrix: a synthetic tissue substrate as an alternative to local complex surgical reconstruction of excisional skin cancer defects

Abstract

Novosorb Biodegradable Temporising Matrix (BTM) is a fully synthetic, two-layer polyurethane dermal substitute that promotes regeneration of deeper skin tissues. It has emerged as a cost-­effective alternative for managing complex wounds, including skin and soft-tissue trauma, burns, and deep or infected defects. This abstract summarizes a 16-case series evaluating the use of BTM for reconstruction of challenging postsurgical defects following Mohs surgery or simple wide local excision. Between October and December 2025, 16 patients underwent excision of various cutaneous malignancies, including basal cell carcinoma, squamous cell carcinoma, pleomorphic dermal sarcoma and melanoma. These procedures resulted in sizeable defects in anatomically and cosmetically sensitive locations, such as the nose, ear with cartilage exposure, scalp with bone exposure, cheek, lip and lower limb. BTM was selected for defects where complex flap reconstruction would have necessitated hospital admission or posed a higher risk of complications, the reconstruction of large multiple facial sub­units, or deep wounds unsuitable for immediate full-thickness skin grafting. Patient-related considerations, particularly the need for simplified postoperative care, were also considered in reconstructive decision making. The cohort included eight men and eight women, all aged > 40 years. Defect sizes ranged from 1 to 9 cm. After BTM insertion, the patients were reviewed weekly for 4 weeks to monitor healing and infection. Bacterial-binding dressings (Sorbact) were routinely used to minimize infection risk. All wounds healed successfully by secondary intention without the need for subsequent skin grafting, achieving excellent cosmetic and functional outcomes. Overall, this case series demonstrates that BTM is a reliable and versatile reconstructive option for complex sizeable defects with a difficult location. Its ability to facilitate secondary intention healing simplifies postoperative management, allows excellent aesthetic results, and reduces both patient burden and healthcare resource utilization. BTM is a very useful tool in the reconstructive ladder of the dermatological surgeon.