Conway Luke, Snashall Emma, Gill Parneet, Harper-Machin Aenone
From the Mersey Regional Burns and Plastic Surgery Centre, Whiston Hospital, Liverpool, United Kingdom.
Plast Reconstr Surg Glob Open. 2025 Apr 29;13(4):e6702. doi: 10.1097/GOX.0000000000006702. eCollection 2025 Apr.
Skin cancer defects in the head and neck can pose a reconstructive challenge. We aimed to evaluate our experience of Novosorb biodegradable temporizing matrix (BTM) in reconstructing complex defects in the head and neck region.
Assessment of all patients where BTM was used for head and neck skin cancer reconstruction was undertaken at our facility. This included tumor type; defect size; second-stage reconstruction (SSR) method; and complications, including failure.
Fifty-four patients were identified with 63 lesions reconstructed with BTM. The mean age was 79. Histology was squamous/basosquamous carcinoma in 40 cases (63%), basal cell carcinoma in 15 cases (24%), and melanoma in 3 cases (5%). The anatomical region reconstructed was the scalp in 46 cases (73%) and the nose in 13 cases (21%). Mean maximum defect diameter was 67 mm. In 27 cases (43%), a previous wide local excision demonstrated an involved or close (<1 mm) margin. BTM was applied to burred bone in 24 of these cases (89%). SSR occurred via use of split-thickness skin graft (68%), full-thickness skin graft (14%), or via secondary intention (17%). One (1%) patient died before SSR, unrelated to BTM. SSR was carried out at a mean of 51 days. Five areas of 63 (8%) experienced a failure to fully heal, identified as due to recurrent or residual disease, causing wound breakdown. No significant infections were observed.
BTM offers a safe, reliable option for complex head and neck cancer reconstruction, particularly in patients unable to undergo more complex procedures.
头颈部皮肤癌缺损会带来重建挑战。我们旨在评估使用Novosorb可生物降解临时基质（BTM）对头颈部区域复杂缺损进行重建的经验。
对在我们机构接受BTM用于头颈部皮肤癌重建的所有患者进行评估。这包括肿瘤类型、缺损大小、二期重建（SSR）方法以及并发症，包括失败情况。
共确定54例患者，用BTM重建了63处病变。平均年龄为79岁。组织学类型为鳞状/基底鳞状细胞癌40例（63%），基底细胞癌15例（24%），黑色素瘤3例（5%）。重建的解剖区域为头皮46例（73%），鼻子13例（21%）。平均最大缺损直径为67毫米。27例（43%）患者之前的广泛局部切除显示切缘受累或切缘接近（<1毫米）。其中24例（89%）在打磨后的骨面上应用了BTM。SSR通过使用中厚皮片（68%）、全厚皮片（14%）或二期愈合（17%）进行。1例（1%）患者在SSR前死亡，与BTM无关。SSR平均在51天进行。63处中有5处（8%）未能完全愈合，原因是疾病复发或残留，导致伤口裂开。未观察到明显感染。
BTM为复杂的头颈部癌症重建提供了一种安全、可靠的选择，特别是对于无法接受更复杂手术的患者。
