Dermal Equivalents in Oncology: Benefit of One-Stage Procedure

Pauchot, J.; Elkhyat, Ahmed; Rolin, Gwenaël; Mac, Sophie; Grumblat, A.; Fotso, Arnaud; Humbert, Philippe; Tropet, Y.

doi:10.1111/dsu.12044

Cited by 10 publications

(18 citation statements)

References 23 publications

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“…We performed the first review of the literature about studies that describe dermal substitutes’ utilisation in reconstruction after skin tumour excision. Table enlists publications available until July 2017 …”

Section: Discussionmentioning

confidence: 99%

Skin cancers and dermal substitutes: Is it safe? Review of the literature and presentation of a 2‐stage surgical protocol for the treatment of non‐melanoma skin cancers of the head in fragile patients

Marcasciano

Mazzocchi

Kaciulyte

et al. 2018

International Wound Journal

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Non-melanoma skin cancers (NMSC) represent the most common skin tumours of the head region. We describe the use of dermal substitute in a 2-stage surgery protocol for selected fragile patients to remove NMSC of the head region. A review of the literature focusing on dermal substitutes' safety after skin tumours excision is provided. A total of 45 fragile patients with NMSC in the head region were selected and scheduled for the 2-stage surgical protocol. The first stage consisted of traditional surgical excision and immediate coverage with Hyalomatrix (Fidia Advanced Biopolymers, Abano Terme, Italy). After histology confirmed diagnosis and clearance of the margins, full-thickness skin autografts were performed. All of the patients reached complete tumour excision and wound healing. No local recurrences were registered during 24 months follow up. The 2-stage surgical therapeutic-diagnostic-reconstructive approach represents a less stressful and oncologically safe surgical protocol in selected fragile patients. When patients cannot tolerate invasive and long surgical procedures, general anaesthesia, and long hospitalisation, skin grafting following temporary skin substitute coverage can achieve oncological clearance and provide good functional and aesthetic results. The use of dermal substitutes represents a valid alternative surgical option in cases of ASA III, fragile patients non-eligible for complex reconstructive surgery. To our knowledge, this is the first paper reviewing literature focusing on dermal substitutes' applications and safety after skin tumour excision.

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Section: Discussionmentioning

confidence: 99%

Skin cancers and dermal substitutes: Is it safe? Review of the literature and presentation of a 2‐stage surgical protocol for the treatment of non‐melanoma skin cancers of the head in fragile patients

Marcasciano

Mazzocchi

Kaciulyte

et al. 2018

International Wound Journal

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“…After wound bed conditioning -approximately after 7 days -these dermal substitutes are removed and autografting can be performed. Autologous cell-containing fibrin glues [Marcelo et al, 2012] or Integra ® [Pauchot et al, 2013] are alternatives that are permanent and do not have to be removed from the wound. Their healing times range from 21 days to 18 weeks.…”

Section: Discussionmentioning

confidence: 99%

Development and Characterization of an Engraftable Tissue-Cultured Skin Autograft: Alternative Treatment for Severe Electrical Injuries?

Golinski¹,

Menke²,

Hofmann³

et al. 2014

Cells Tissues Organs

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Background/Aims: Optimizing the treatment regimens of extensive or nonhealing defects is a constant challenge. Tissue-cultured skin autografts may be an alternative to mesh grafts and keratinocyte suspensions that are applied during surgical defect coverage. Methods: Autologous epidermal and dermal cells were isolated, in vitro expanded and seeded on collagen-elastin scaffolds. The developed autograft was immunohistochemically and electron microscopically characterized. Subsequently, it was transplanted onto lesions of a severely burned patient. Results: Comparability of the skin equivalent to healthy human skin could be shown due to the epidermal strata, differentiation, proliferation markers and development of characteristics of a functional basal lamina. Approximately 2 weeks after skin equivalent transplantation the emerging new skin correlated closely to the adjacent normal skin. Conclusion: The present study demonstrates the comparability of the developed organotypic skin equivalent to healthy human skin and its versatility for clinical applications.

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“…It has been established that epithelial resurfacing and vertical proliferation were reduced and delayed by application of dermal matrices without affecting apoptosis, cell differentiation, or basement membrane formation . Previous clinical reports have also shown the feasibility of simultaneously applying thin split‐thickness skin grafts over a collagen–elastin matrix for full‐thickness skin reconstruction in burns or cancer reconstruction but lacked an explanation on how the applied skin grafts received nutrients, in other words: how the “mechanism of take” of the skin graft occurred.…”

Section: Discussionmentioning

confidence: 99%

“…However, the subjective assessment of scar quality by use of the Vancouver Scar Scale was not validated for pigs, and an objective assessment of dermal thickness was lacking . We aimed at providing a scientific basis for the explanation of graft supply in a simultaneous application of a dermal matrix and split‐thickness skin graft …”

Section: Discussionmentioning

confidence: 99%

Simultaneous dermal matrix and autologous split‐thickness skin graft transplantation in a porcine wound model: A three‐dimensional histological analysis of revascularization

Wiedner

Tinhofer

Kamolz

et al. 2014

Wound Repair Regeneration

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Despite the popularity of a simultaneous application of dermal matrices and split-thickness skin grafts, scarce evidence exists about the process of revascularization involved. In this study, we aimed at analyzing the progression of revascularization by high-resolution episcopic microscopy (HREM) in a porcine excisional wound model. Following the surgical procedure creating 5 × 5 cm(2) full-thickness defects on the back, one area was covered with an autologous split-thickness skin graft alone (control group), the other with a collagen-elastin dermal matrix plus split-thickness skin graft (dermal matrix group). Two skin biopsies per each group and location were performed on day 5, 10, 15, and 28 postoperatively and separately processed for H&E as well as HREM. The dermal layer was thicker in the dermal matrix group vs. control on day 5 and 28. No differences were found for revascularization by conventional histology. In HREM, the dermal matrix did not appear to decelerate the revascularization process. The presence of the dermal matrix could be distinguished until day 15. By day 28, the structure of the dermal matrix could no longer be delineated and was replaced by autologous tissue. As assessed by conventional histology and confirmed by HREM, the revascularization process was comparable in both groups, notably with regard to the vertical ingrowth of sprouting vessels. The presented technique of HREM is a valuable addition for analyzing small vessel sprouting in dermal matrices in the future.

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Dermal Equivalents in Oncology: Benefit of One-Stage Procedure

Cited by 10 publications

References 23 publications

Skin cancers and dermal substitutes: Is it safe? Review of the literature and presentation of a 2‐stage surgical protocol for the treatment of non‐melanoma skin cancers of the head in fragile patients

Skin cancers and dermal substitutes: Is it safe? Review of the literature and presentation of a 2‐stage surgical protocol for the treatment of non‐melanoma skin cancers of the head in fragile patients

Development and Characterization of an Engraftable Tissue-Cultured Skin Autograft: Alternative Treatment for Severe Electrical Injuries?

Simultaneous dermal matrix and autologous split‐thickness skin graft transplantation in a porcine wound model: A three‐dimensional histological analysis of revascularization

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