Use of an Amorphous Silica-Based Fiber Wound Matrix and Cream in a Post-Mohs Defect of the Dorsal Hand: A Case Report.

Postoperative defects of the dorsal hand following Mohs micrographic surgery may present wound-management challenges because of limited soft-tissue coverage, underlying tendon exposure, mobility, and the potential for functional impairment. We report the clinical course of a 53-year-old patient who underwent Mohs surgery for a biopsy-confirmed keratoacanthoma of the dorsal hand. Following complete removal of the lesion, the surgical defect was managed by secondary intention. Initial postoperative management consisted of Puracol Plus and petrolatum, with granulation coverage of an exposed tendon anticipated within approximately seven weeks. The patient subsequently received an amorphous silica-based fiber (SBF) wound matrix and silica-based cream (SBC) from SiOxMed for home-based self-treatment. SBF was applied daily to the open wound following daily rinsing and reapplication until the wound surface was covered and dry. Serial patient-generated photographs demonstrated granulation tissue covering the previously exposed tendon by Day 26, substantial wound contraction and developing epithelial coverage by Day 45, and complete visible wound coverage by Day 50. SBC was initiated after epithelial coverage was established. A final photograph obtained on Day 118 demonstrated sustained wound closure. This single uncontrolled case cannot establish that SBF or SBC accelerated healing compared with conventional secondary-intention management. However, the observed progression from a postoperative defect with an exposed tendon to granulation coverage, contraction, epithelialization, and sustained closure supports prospective evaluation of this treatment approach in complex postoperative wounds.