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

Ahmed, Salim; Hussein, Syed S.; Philp, Bruce; Healy, Ciaran

doi:10.1111/j.1524-4725.2006.32155.x

Cited by 14 publications

(17 citation statements)

References 5 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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“…59 The bilayer device has also been used to treat defects of the head and neck, particularly after skin cancer resection, including Mohs' surgery. 60 In small-area defects, the skin reepithelializes over the matrix spontaneously, ejecting the silicone layer and not requiring the subsequent skin graft. For larger defects, the tumor margins can be cleared by permanent histologic sections; if they are positive, additional margins are easily taken during the second-stage skin graft application (Fig.…”

Section: Reduction In Scarringmentioning

confidence: 99%

Template for Skin Regeneration

Yannas

Orgill

Burke

2011

Plastic and Reconstructive Surgery

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“…12 Following Gillie and Millard's 13 principle of replacing Blike for like[ with tissue expanders is not always practical especially in larger oncologic scalp defects. Healing by secondary intention does not work for large full-thickness scalp wounds where bone is devoid of periosteum.…”

Section: Discussionmentioning

confidence: 99%

Use of Dermal Regeneration Template (Integra) for Reconstruction of Full-Thickness Complex Oncologic Scalp Defects

Khan

Ali

Farid

et al. 2010

Journal of Craniofacial Surgery

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The reconstruction of full-thickness scalp defects remains a surgical challenge. Different types of reconstruction had varying success including the use of dermal regeneration template (DRT). We reviewed the surgical outcome of 30 patients who underwent application of DRT for resurfacing of full-thickness scalp defects when the pericranium was excised and the outer cortex of the calvarial bone was burred after the excision of scalp neoplasm. This was a retrospective review of 30 patients who had scalp reconstruction with DRT undertaken by the senior author between October 2004 and June 2007. The mean age of patients in our series was 63 years (37-91 years). There were 14 men and 16 women. The indications for re-excision and DRT reconstruction in 28 patients were close margins and aggressive tumor type, whereas 2 patients had a recurrence. The mean defect size was 95 cm2 (16-275 cm2). The second stage of the reconstruction occurred on postoperative day 42 (postoperative days 27-62). The mean follow-up period was 14 months. Two patients had minor complications. For both stages, the combined average operative time was 128 minutes. The use of DRT is a rung of the reconstructive ladder that deserves consideration. In our series of 30 patients who required secondary reconstruction of complex scalp defects, the use of DRT has been seen to provide safe and durable soft-tissue cover for full-thickness scalp defects. The reduced operative time and inpatient stay are desirable characteristics particularly in elderly patients with multiple comorbidities.

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

Cited by 14 publications

References 5 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

Template for Skin Regeneration

Use of Dermal Regeneration Template (Integra) for Reconstruction of Full-Thickness Complex Oncologic Scalp Defects

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