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Oncologic resection of cutaneous malignancies often results in soft-tissue defects traditionally reconstructed with skin grafts or flaps. Ovine Forestomach Matrix (OFM) is a decellularized extracellular matrix containing collagens, proteins, and polysaccharides to support tissue regeneration. Although typically employed to prepare wound beds for grafting, our recent case-series showed that OFM alone could promote granulation and epithelialization over bone and tendon. To reduce risks and costs associated with grafting, we evaluated the use of OFM as a standalone reconstructive option for post-excision defects in skin cancer patients. We performed a single-center, retrospective review of 30 consecutive patients who received OFM for primary reconstruction during cutaneous malignancy resection from 9/3/24 to 12/9/25. Demographics and wound-healing comorbidities (diabetes mellitus, smoking history, and immunosuppression) were recorded along with malignancy and wound characteristics. Primary outcome was the time to clinical determination of healing. Secondary outcomes included 30-, 60-, and 90-day complications. Of the 30 patients, 20 were male (67%) and 10 were female (33%). The average age was 69 (range 35-86) and mean BMI 28.5 (range 22.2-44.6). All patients identified as White/Non-Hispanic. Four patients were immunosuppressed (13%) and 7 were diagnosed with diabetes mellitus (23%). Tobacco users made up 17% of the cohort. Malignant melanoma was diagnosed most commonly, with pathologic stage IA. Mean wound size was 39.8 cm2 (range 3-300 cm2). Twelve patients have fully healed (40%), with an average healing time of 4.1 months (Range: 0.9-8.8 months). Three patients developed surgical site infections, but only one at the graft site. None required surgical intervention. Hypergranulation occurred in seven patients. Our experiences demonstrate the novel application of OFM as an effective reconstructive approach for patients who wish to avoid graft-related risks or additional procedures. Outcomes were most convincing in locations where graft failure is common (ankle and heel) or where cosmesis may be less important to the patient (lower leg and back). Moreover, donor site morbidity was avoided. Pre-operative counseling remains essential to prepare patients with larger defects for extended periods of healing and wound care; however, OFM does not prohibit delayed graft placement.