Purpose:
 Fungating malignant wounds are associated with significant morbidity, including pain, malodour, and psychosocial distress. Surgical options are often limited in patients with advanced metastatic disease, and the role of dermal substitutes such as biodegradable temporising matrix (BTM) in palliative wound care is not well described. Methodology:
We report the case of a 61-year-old woman with metastatic cervical cancer who developed a large fungating, malodorous metastatic lesion over the thoracic spine. The lesion caused significant distress and impaired quality of life. Following multidisciplinary discussion and extensive consultation with the patient and her whānau, a palliative surgical approach was undertaken. The procedure involved debulking of the metastatic deposit over the thoracic spine, followed by application of BTM to manage the resultant soft tissue defect. The intent of surgery was symptom control rather than cure, with clear pre-operative counselling regarding risks, limitations, and goals of care. Results:
Post-operatively, the wound demonstrated satisfactory integration of BTM, with resolution of malodour and manageable exudate. At follow-up, the patient reported improved comfort and was able to engage in meaningful activities with her whānau, including travel. Limitations of this approach include the requirement for continued dressing changes and clinic follow-up. Aside from the upfront costs of surgery and BTM, this strategy did not incur substantial additional resource and proved to be a cost-effective means of symptom control. Although there was later evidence of probable recurrent carcinoma, the wound remained non-malodorous and did not require immediate re-intervention. Conclusion: This case highlights the potential role of BTM as a palliative adjunct in managing complex malignant wounds. BTM may offer symptom relief and improved quality of life, supporting its consideration within a multidisciplinary palliative care framework.