Use of Biologic Dressing as a Temporary Wound Dressing in Reconstruction of a Significant Forehead Mohs Defect

Biologic Dressings

“…59 There have also been several case series reporting the utility of Integra in the reconstruction of large full-thickness scalp defects in patients with cutaneous malignancy, including melanoma, squamous cell carcinoma, basal cell carcinoma, and angiosarcoma. 31,[59][60][61] One case series included 23 patients with full-thickness scalp defects with at least partial absence of pericranium (average defect size 51 cm 2 , range 9-169 cm 2 ) and resulted in all patients achieving a closed scalp defect with no evidence of exposed bone. 60 The average time from placement of the construct to regeneration of a significant wound bed to allow for autografting was 30 days.…”

“…31 There is one case report of the use of Integra in the reconstruction of a significant forehead defect after Mohs micrographic excision of a morpheaform basal cell carcinoma. 61 It was been reported to be beneficial in a single-case report in the reconstruction of a large 10-Â 15-cm defect after excision of a squamous cell carcinoma in a patient with dominant dystrophic epidermolysis bullosa. 62 These cases all share the similar feature of a large surgical defect requiring some amount of soft tissue bulk to recreate good contours and for coverage of underlying structures, such as bone.…”

“…Successful application of Integra in the reconstruction of defects created by excision of giant hairy nevi has been reported in a series of four cases 59 . There have also been several case series reporting the utility of Integra in the reconstruction of large full‐thickness scalp defects in patients with cutaneous malignancy, including melanoma, squamous cell carcinoma, basal cell carcinoma, and angiosarcoma 31,59–61 . One case series included 23 patients with full‐thickness scalp defects with at least partial absence of pericranium (average defect size 51 cm 2 , range 9–169 cm 2 ) and resulted in all patients achieving a closed scalp defect with no evidence of exposed bone 60 .…”

“…Another case series of seven patients with partial‐ and full‐thickness soft tissue defects of the scalp after resection of cutaneous malignancy showed 100% graft take with no infections or other complications 31 . There is one case report of the use of Integra in the reconstruction of a significant forehead defect after Mohs micrographic excision of a morpheaform basal cell carcinoma 61 . It was been reported to be beneficial in a single‐case report in the reconstruction of a large 10‐ × 15‐cm defect after excision of a squamous cell carcinoma in a patient with dominant dystrophic epidermolysis bullosa 62 .…”

Long‐term results after reconstruction of full thickness scalp defects with a dermal regeneration template

“…Integra ® has been used in burn surgery 4–11 and for the treatment of various other deep and extended skin defects 12–17 . Moreover, several studies have shown the efficiency of Integra ® in oncological surgery of the scalp 18–22 . Recently, we have shown that large full thickness scalp defects in which the pericranium had to be resected can reliably be reconstructed using Integra ® when the outer table of the skull was partially removed using a high‐speed drill to allow vascularization of Integra from the marrow 22 .…”