Vacuum-Assisted Closure Device and Skin Substitutes for Complex Mohs Defects

Cunningham, Teresa; Marks, Malcolm W.

doi:10.1097/dss.0000000000000113

Cited by 19 publications

(18 citation statements)

References 19 publications

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“…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%

“…VAC was the most common postoperative wound dressing (32%). 19,22,24,27,28,33,35,38 These studies reported percent take of 50–100%, with 87.5% of studies reporting percent take >98%. Bolstered dressings (28%) and silver-impregnated dressing materials (24%) were also popular, with percent take ≥90% in all cases.…”

Section: Resultsmentioning

confidence: 99%

“…51 Accordingly, it was the most popular bolster method used in this systematic review, including studies with the largest mean defect sizes (Table 6). Cunningham and Marks 35 reported 100% graft take in a patient with a 400 cm 2 wound who was treated postoperatively with VAC. Similarly, Konofaos et al 38 reported 98% graft take in a pediatric patient with total scalp avulsion resulting in a 610 cm 2 defect.…”

Section: Discussionmentioning

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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“…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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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show abstract

“…Vacuum-assisted closure has been used in the clinical treatment of extensive and complex wounds for almost two decades [2]. It is well documented that VAC accelerates wound healing by improving angiogenesis and granulation tissue formation and decreasing bacterial load [3]. Nevertheless, it is not uncommon that clinically some chronic wounds show no progress of regeneration even after long-term VAC intervention, especially in the presence of diabetes mellitus (DM), therefore necessitating adjunctive treatments.…”

mentioning

confidence: 99%