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This case report describes BTM-assisted secondary intention healing of an infected scalp wound in a medically complex patient after failed split-thickness skin grafting. Substantial granulation and neodermis formation led to the second-stage grafting being judged unnecessary. The report supports BTM as a potential definitive option for high-risk patients with impaired healing capacity and for managing complex wounds when conventional reconstruction is contraindicated or has failed.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/secondary-intention-healing-with-biodegradable-temporizing-matrix-btm-in-a-comorbid-patient-a-case-report/453011/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/secondary-intention-healing-with-biodegradable-temporizing-matrix-btm-in-a-comorbid-patient-a-case-report/453011.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the typical role of biodegradable temporizing matrix (BTM) in wound reconstruction?","Question",{"text":112,"@type":113},"BTM is a fully synthetic dermal substitute used for complex wounds and is typically applied in a two-stage process to optimize the wound bed before grafting.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What outcome occurred in this case after using BTM?",{"text":117,"@type":113},"The infected scalp wound healed by secondary intention, with enough granulation and neodermis formation that planned second-stage grafting was ultimately not required.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was BTM considered particularly relevant for this patient?",{"text":121,"@type":113},"The patient had significant comorbidities and prior skin graft failure, indicating impaired healing capacity and limiting conventional reconstructive options.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},453011,1790774708,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","JPRAS Open 48 (2026) 351–355  \nContents lists available at ScienceDirect  \nJPRAS Open  \njournal [homepage:](homepage: www.elsevier.com/locate/jpra)[ www.elsevier.com/locate/jpra](homepage: www.elsevier.com/locate/jpra)  \n| Case Report\u003Cbr>Secondary intention healing with biodegradable temporizing matrix (BTM) in a comorbid patient: A case report\u003Cbr>Ho Yin Kama,∗, Yuet Ching Wongb, Stephen Goldie a,c\u003Cbr>a Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Tasmania, 7000, Australia b School of Medicine, University of Tasmania, Hobart, Tasmania, 7000, Australia\u003Cbr>c Department of Surgery, Monash University, Melbourne, Victoria, 3168, Australia |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 19 September 2025\u003Cbr>Accepted 16 November 2025\u003Cbr>Available online 23 November 2025 |  | Biodegradable temporizing matrix (BTM) is a synthetic dermal substitute designed for complex wound reconstruction, typically in a two-stage process. We present a case involving BTM-assisted healing by secondary intention of an infected scalp wound in a medically complex patient following failed split-thickness skin grafting. Owing to substantial granulation and neodermis formation, the planned second-stage grafting was ultimately deemed unnecessary. This case highlights BTM’s potential as a definitive reconstructive option in high-risk patients with impaired healing capacity and supports its role in managing complex wounds, particularly when conventional reconstructive strategies are contraindicated or have failed.\u003Cbr>© 2025 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license\u003Cbr>([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)) |\n| Keywords:\u003Cbr>Skin neoplasm\u003Cbr>Biodegradable temporizing matrix BTM\u003Cbr>Wound healing |  |  |\n\nIntroduction  \nCutaneous squamous cell carcinoma (cSCC) is the second most common cancer in Australia after basal cell carcinoma, accounting for about one-third of non-melanoma skin cancers.1 It typically  \n∗ Corresponding author.  \nE-mail [address:](address: gjkhdkjyu@gmail.com)[ gjkhdkjyu@gmail.com](address: gjkhdkjyu@gmail.com) (H.Y. Kam).  \n[https://doi.org/10.1016/j.jpra.2025.11.020](https://doi.org/10.1016/j.jpra.2025.11.020)  \n2352-5878/© 2025 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/))  \nH.Y. Kam, Y.C. Wong and S. Goldie JPRAS Open 48 (2026) 351–355  \narises on sun-exposed areas, especially the head and neck. Surgical excision is the primary treatment and is curative with adequate margins.1 Secondary non-oncological goals of treatment include maintaining function and cosmesis, and often necessitates the use of complex reconstructive techniques, particularly in the case of larger, more aggressive and deeply invasive lesions, such as skin graft or flaps.  \nThe biodegradable temporizing matrix (BTM, Novosorb, PolyNovo Biomaterials Pty Ltd., Port Melbourne, VIC, Australia) is a fully synthetic dermal substitute designed for the reconstruction of complex wounds.2 , 3 It is typically used in a two-stage wound reconstruction process, serves as a transitional phase to optimize the wound bed before grafting.4 We present a case report and serial clinical images demonstrating BTM-assisted healing solely via secondary intention of a large, infected scalp vertex wound in a patient with significant comorbidities and previous skin graft failure.  \nCase report  \nA 60-year-old male presented with a 25 × 24 mm biopsy proven ulcerated, moderately differentiated squamous cell carcinoma lesion of the scalp vertex (Figure 1A), subsequently underwent an excision of the lesion w","cbCaijQkudkmgX65","https://ap.wps.com/l/cbCaijQkudkmgX65","pdf",871542,"English","# Case Report\n## Introduction\n## Case report","[{\"question\":\"What is the typical role of biodegradable temporizing matrix (BTM) in wound reconstruction?\",\"answer\":\"BTM is a fully synthetic dermal substitute used for complex wounds and is typically applied in a two-stage process to optimize the wound bed before grafting.\"},{\"question\":\"What outcome occurred in this case after using BTM?\",\"answer\":\"The infected scalp wound healed by secondary intention, with enough granulation and neodermis formation that planned second-stage grafting was ultimately not required.\"},{\"question\":\"Why was BTM considered particularly relevant for this patient?\",\"answer\":\"The patient had significant comorbidities and prior skin graft failure, indicating impaired healing capacity and limiting conventional reconstructive options.\"}]","Secondary intention healing with biodegradable temporizing matrix (BTM) in a comorbid patient - A case report | PDF",1790738047,13]