The Use of Biodegradable Temporizing Matrix in Reconstruction Postvascular Anomaly Excision in the Pediatric Patient

Background: Reconstructing sites postvascular anomaly excision, particularly in high-tension areas or large excision zones, is challenging and often requires full-thickness grafts or flaps. The consideration of long-term scar outcomes, especially in pediatric cases, is crucial to prevent scar contractures from hindering growth. Acellular dermal matrices, such as biodegradable temporizing matrix (BTM), provide a valuable alternative reconstructive option following vascular anomaly excision. Objective: This article describes a reconstructive technique used for children undergoing excision of vascular anomalies via a case series of patients managed with this technique. Methods: This is a prospective study of 10 consecutive pediatric patients who underwent BTM reconstruction postvascular anomaly excision at a tertiary pediatric hospital. The indications for excision, the operative process for each child, postoperative management, and subsequent scar outcomes are described. The Brisbane Burn Scar Impact Profile was used to assess scar outcomes. Results: A range of vascular anomalies were excised, involving up to 15% of the total body surface area. In these patients, BTM served as a neodermis for subsequent split-thickness skin grafting. There was partial split skin graft loss in 2 patients, but in no cases was the dermal template lost, nor were there any cases of sepsis. Symptom control was achieved in all patients. Conclusions: In our experience, BTM offers a practical and safe reconstructive option for pediatric patients requiring excision of their vascular anomaly. It spares patients from more extensive procedures, has low rates of infection, and provides acceptable scar results.