McMahon Mary Ellen, Browne Robert, Ibrahim Safwat
From the Department of Plastic and Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland.
Department of Surgery, Royal College of Surgeons Ireland, Dublin, Ireland.
Plast Reconstr Surg Glob Open. 2025 Jan 27;13(1):e6492. doi: 10.1097/GOX.0000000000006492. eCollection 2025 Jan.
The use of PolyNovo NovoSorb biodegradable temporizing matrix (BTM) has become popular for the management of complex wounds, often with the subsequent application of a split-thickness skin graft. To date, there are no published case series describing healing via secondary intention over BTM in the management of small, complex nasal wounds following excision of skin malignancy in the elective setting.
This study consisted of a single-center, consecutive case series. Inclusion criteria consisted of defects with exposed cartilage or bone in wounds located on the nasal dorsum or nasal sidewall resulting from the elective excision of nasal skin malignancies. BTM without skin grafting was used as a single-stage reconstruction in all patients following oncological clearance. After delamination, the wound was left to heal by secondary intention. The Patient and Observer Scar Assessment Scale was used to measure the aesthetic outcome.
All 32 cases exhibited 100% integration of BTM and successful wound closure. Two cases required further excision following review of the final histology. The median (SD) overall Patient and Observer Scar Assessment Scale score was 2.7 (±0.81), and the median overall observer score was 3.2 (±0.73).
When planning nasal reconstruction following oncological resection, one should consider the patient's comorbidities; their ability to tolerate the anesthetic, surgery, donor skin deficit, and risks; and the technical ability of the operating surgeon. We suggest that the use of BTM without harvesting a skin graft represents a simple, low-risk option for reconstruction of nasal defects that produces acceptable functional and aesthetic outcomes.
PolyNovo NovoSorb可生物降解临时基质（BTM）在复杂伤口处理中已广泛应用，通常随后会进行中厚皮片移植。迄今为止，尚无已发表的病例系列描述在择期切除皮肤恶性肿瘤后，小型复杂鼻伤口处理中通过BTM二期愈合的情况。
本研究为单中心连续病例系列。纳入标准包括因择期切除鼻皮肤恶性肿瘤导致鼻背或鼻侧壁伤口出现软骨或骨外露的缺损。所有患者在肿瘤清除后，均采用不进行皮肤移植的BTM进行一期重建。分层后，伤口通过二期愈合。采用患者和观察者瘢痕评估量表来测量美学效果。
所有32例病例中BTM均实现100%整合且伤口成功闭合。2例在最终组织学检查后需要进一步切除。患者和观察者瘢痕评估量表总分的中位数（标准差）为2.7（±0.81），观察者总分中位数为3.2（±0.73）。
在规划肿瘤切除后的鼻重建时，应考虑患者的合并症、其耐受麻醉、手术、供皮区皮肤缺损及风险的能力，以及手术医生的技术能力。我们建议，不进行皮片采集而使用BTM是一种简单、低风险的鼻缺损重建选择，可产生可接受的功能和美学效果。
