Multistep Heel Reconstruction After Marjolin Ulcer Resection
A case series in *Wounds* (June 17, 2025) details four patients undergoing multistep reconstruction of the heel following resection of Marjolin ulcers—aggressive skin cancers arising in chronic wounds. Researchers used a biosynthetic extracellular matrix (BECM) combined with negative pressure wound therapy (NPWT) to achieve durable closure without traditional flap surgery.
Key Highlights:
- Patient Population: Four adults with posttraumatic chronic leg ulcers, including a 58-year-old male with diabetes, venous insufficiency, obesity, smoking, and a Marjolin ulcer on the heel. :contentReference[oaicite:1]{index=1}
- Multistep Protocol:
- Wide surgical excision of tumor + placement of BECM with 28 days of NPWT
- Application of split-thickness skin graft and 7 additional days of NPWT
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- Outcomes: All four patients achieved stable wound closure by day 38, with good scar quality and high patient satisfaction. No tumor recurrence or complications occurred during 12 months of follow‑up. :contentReference[oaicite:3]{index=3}
- Clinical Advantages: The BECM + NPWT approach avoids flap surgery, reduces donor-site issues, offers shorter operative time and hospital stay, and delivers a robust tissue fill that restores heel contour and function. :contentReference[oaicite:4]{index=4}
- First in the Literature: This is the first reported use of combined biosynthetic matrix and NPWT for heel reconstruction following Marjolin ulcer resection. :contentReference[oaicite:5]{index=5}
A multistep reconstruction strategy using biosynthetic scaffold plus NPWT offers a practical, less invasive solution for complex heel defects—achieving functional and aesthetic outcomes without flaps or extensive surgery.
Read the full case series in Wounds (HMP Global Learning Network).
Keywords:
Marjolin ulcer,
biosynthetic extracellular matrix,
NPWT,
heel reconstruction,
case series