P141 Biodegradable temporizing matrix: a first for dermatological surgery and a valuable reconstructive adjunct

Abstract Biodegradable temporizing matrix (BTM) has emerged as a significant adjunct to postsurgical wound management. It is a synthetic polyurethane dermal substitute and typically involves a two-step process of initial placement, followed by the application of a split-thickness skin graft to the neodermis. BTM is frequently used by plastic surgeons in this way; however, dermatologists have yet to report its application. We report the use of BTM to facilitate secondary intention healing in a dermatological surgery setting where conventional reconstruction options were limited. Seven patients were included with an average age of 67 years (range 51–86). All patients underwent excision of basal cell carcinoma. Six patients underwent Mohs micrographic surgery and one had standard surgical excision. Tumour locations were mostly on the nose (six), the singular other site was the parietal scalp. Reasons for using BTM to facilitate wound closure included risk of alar rim retraction, defects spanning multiple facial subunits and defects too deep for successful immediate full-thickness skin grafting. All patients healed by secondary intention, and no skin grafts were necessary. Patients attended weekly for wound review and dressing changes, and were discharged from the dressing clinic between 4 and 14 weeks postoperatively. Two patients were treated for a Staphylococcal aureus wound infection with oral antibiotics. Excellent cosmetic outcomes were observed for all patients. BTM is a valuable adjunct to the reconstructive ladder for the dermatological surgeon. In conjunction with secondary intention healing, it can reduce the number of surgical interventions, simplify the postoperative care regimen and enhance the overall cosmetic and functional outcomes for patients.