The Use of Novosorb Biodegradable Temporizing Matrix for Reconstruction in Head and Neck Cancer: A Simple Answer to a Complex Problem.

Background: 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. Methods: 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. Results: 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. Conclusions: BTM offers a safe, reliable option for complex head and neck cancer reconstruction, particularly in patients unable to undergo more complex procedures.