The use of Dermal Regeneration Template (Integra®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura

Khan, Muhammad Adil Abbas; Chipp, Elizabeth; Hardwicke, Joseph; Srinivasan, Karthik; Shaw, Simon; Rayatt, Sukh

doi:10.1016/j.bjps.2010.03.017

Cited by 40 publications

(19 citation statements)

References 10 publications

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“…Five studies reported time to second stage >30 days. 12,14,20,24,36,37 All five reported a complication accounting for the delay.…”

Section: Resultsmentioning

confidence: 99%

“…Burring was employed in 74.2% of the studies included in this systematic review, with percent take ranging from 50% to 100% (Table 4). 10,12,14,15,17–20,22–24,27,28,30–34,36–38,40 Percent take was >90% in studies not employing bone burring. 9,11,12,16,17,29,35,39,41 …”

Section: Resultsmentioning

confidence: 99%

“…The remaining 22 articles using unfenestrated Integra reported percent take ranging from 50% to 100%. 9–11,14–16,18–20,22–25,27,31–35,37,39,42 Fung et al 37 reported hematoma formation under unfenestrated Integra resulting in 90% graft take.…”

Section: Resultsmentioning

confidence: 99%

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Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature

Johnson

Wong

2016

Plastic and Reconstructive Surgery - Global Open

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Background:Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects.Methods:A comprehensive systematic review was completed using key search terms, including Integra, dermal regeneration template, bovine collagen, skin substitute, forehead, and scalp. Selected articles reported characteristics of patients and their reconstructions. The primary outcome measures were wound complications and percent graft take.Results:Thirty-four articles were included in this systematic review. Wound sizes ranged from 5.7 to 610 cm2, with 35.3% of articles reporting a mean defect size >100 cm2. Thirty-two articles reported mean percent take of skin graft ≥90%. Sixteen articles reported a minor complication. There were no major complications associated with the reconstructions.Conclusions:There is a substantial evidence base for the use of Integra to reconstruct scalp wounds. To date, the dermal regeneration template is generally reserved for salvage procedures or when the patient cannot tolerate free tissue transfer. Based on the findings of this systematic review and the authors’ clinical experience, Integra can be used to achieve predictable results in large complex scalp defects.

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“…Five studies reported time to second stage >30 days. 12,14,20,24,36,37 All five reported a complication accounting for the delay.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature

Johnson

Wong

2016

Plastic and Reconstructive Surgery - Global Open

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“…Significantly, most of these techniques can provide only scarce to moderate aesthetic results. Soon after their introduction in clinical practice, regenerative dermal templates have proved to be a reliable and valuable resource for the reconstructive management of many postsurgical defects . The template allows a prompt and effective reconstruction by means of a low invasive surgery and without any sacrifice of major autologous donor areas.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, numerous studies have provided evidence that a wide surgical excision (<2.5 cm margins) or a more conservative Mohs micrographic surgery can significantly affect the rate of recurrences: nonetheless, literature has scarcely investigated how to best profit from novel reconstructive strategies . Regenerative dermal templates have been successfully adopted in the management of malignant cutaneous tumors of the scalp for which their use is now well established . Even so, they have never been described in the management of facial dermatofibrosarcoma protuberans.…”

Section: Introductionmentioning

confidence: 99%

Reconstructive strategies for dermatofibrosarcomas of the face: Role of regenerative dermal templates

et al. 2014

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Evaluating the effects of vacuum on the microstructure and biocompatibility of bovine decellularized pericardium

Alizadeh

Rezakhani

Khodaei

et al. 2020

J Tissue Eng Regen Med

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The aim of this study was evaluating the effects of vacuum on microstructure and biocompatibility of bovine decellularized pericardium. So the bovine pericardia were decellularized and then the vacuum was applied for two periods of time; 90 and 180 min. DNA, glucose amino glycan, collagen and elastin content assay, scanning electron microscopy (SEM) examination, hematoxylin and eosin (H&E) and Masson's trichrome stainings performed to evaluate microstructure of tissues. MTT (3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide) test, subcutaneous implantation, and tensile test were used to assay biocompatibility and mechanical properties of decellularized tissues. The results showed that applying vacuum reduced residual DNA significantly. Vacuum after 180 min reduced more residual DNA. There were no significant differences in the content of glucose amino glycan (GAG), collagen, and elastin between the vacuumed and control groups. SEM examination was revealed that vacuum for 180 min increased pore size and porosity more than 90 min and control groups. H&E and Masson's trichrome stainings revealed extracellular matrix preservation after decellularization in all groups. Cell viability was increased in vacuumed samples significantly after 72 h in vaccumed samples. H&E staining and tensile test after implantation of tissues were showed less inflammation in the vacuum applied tissues and increased durability. The vacuum increased DNA removal, pore size, porosity, and biocompatibility in vitro and in vivo and durability of bovine decellularized pericardium in vivo. Considering the important role of time, more studies should be performed to optimize time, intensity, and method of application of vacuum in decellularization of different tissues as well as bovine pericardium.

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The use of Dermal Regeneration Template (Integra®) for reconstruction of a large full-thickness scalp and calvarial defect with exposed dura

Cited by 40 publications

References 10 publications

Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature

Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature

Reconstructive strategies for dermatofibrosarcomas of the face: Role of regenerative dermal templates

Evaluating the effects of vacuum on the microstructure and biocompatibility of bovine decellularized pericardium

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