Biodegradable temporizing matrix: Early experience in reconstruction of complex wounds and potential future applications

ABSTRACT Introduction: Surgeons often face complex wounds with full-thickness defects of the skin and difficult wound beds. A difficult wound bed is one with exposed bones, tendons, and joints. Traditionally such wounds are resurfaced with skin grafts alone or with flaps. Sometimes, there is a paucity of local tissue and complex reconstructive procedures are contraindicated or unsafe, particularly in frail, unstable patients. We must look at other available means of reconstruction. Here, we present a series of cases where defects were reconstructed using a biodegradable temporizing matrix (BTM) followed by a split-thickness skin graft (STSG). Materials and Methods: Records at our center were retrospectively reviewed from 2021 to 2024. Nine patients with complex wounds (exposed underlying structures in the wound bed, including bones, tendons, and joints) were identified and underwent reconstruction using a BTM. The matrix was placed into the defect at the first stage followed by skin grafting at the second stage. Nine patients (five males, four females) with a mean age of 45 years with skin defects ranging from 2 × 2 to 12 × 8 cm 2 were included in the study. After an average of 21 days, patients underwent placement of an STSG over the vascularized temporizing matrix. Results: The STSG took well in every patient with no complications or re-operations required. Full-thickness defects of the skin over a difficult wound bed are challenging to reconstruct. Conclusion: This series demonstrates that BTM can re-vascularized and allow an STSG to take with minimal to no complications/morbidity, a relatively short operative time, and a stable outcome.