Reconstruction of Full-Thickness Scalp Defects Using a Dermal Regeneration Template
| Autor: | Jessica P. Lange, Matthew A. Richardson, J. Randall Jordan |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Outcome assessment 03 medical and health sciences Postoperative Complications 0302 clinical medicine Outcome Assessment Health Care medicine Humans 030223 otorhinolaryngology Aged Retrospective Studies Aged 80 and over Skin Artificial Wound Healing Scalp business.industry Regeneration (biology) Chondroitin Sulfates Graft Survival Follow up studies Skin Transplantation Middle Aged Plastic Surgery Procedures Skin transplantation Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Integra artificial skin Free flap reconstruction Female Full thickness Collagen business Follow-Up Studies Biomedical engineering |
| Zdroj: | JAMA Facial Plastic Surgery. 18:62-67 |
| ISSN: | 2168-6092 2168-6076 |
| DOI: | 10.1001/jamafacial.2015.1731 |
| Popis: | Large full-thickness scalp defects pose a reconstructive problem and commonly require microvascular free flap reconstruction.To describe a novel and effective reconstructive technique for full-thickness scalp defects that can be performed quickly without general anesthesia or free flap reconstruction.A retrospective review of 10 patients at a single medical center who underwent surgical resection of a cutaneous lesion. Reconstruction of the large scalp defects included application of Integra bilayer wound matrix followed by delayed split-thickness skin grafting from January 1, 2008, to December 31, 2014. Patients ranged in age from 50 to 87 (mean, 71.5) years; 8 (80%) were men. Mean duration of follow-up was 481.1 days (range, 41-1199 days).Skin graft viability and adherence to underlying tissue (take) and postoperative complications.The 10 patients in this study had excellent skin graft and wound closure outcomes. Nine patients showed a 100% initial take of the skin graft to the defect site. Only 1 patient showed a 95% to 100% initial take. Adequate coverage of the wound bed was achieved with acceptable cosmetic results. Two patients underwent postoperative intensity-modulated radiotherapy. One of these patients experienced radiotherapy-induced wound breakdown 3½ months after completion of therapy, which resolved completely after more than 6 months.This novel technique for reconstruction of large full-thickness scalp defects has low morbidity and can be performed on an outpatient basis with minimal wound care. The technique provides the surgeon with an alternative to other reconstructive options, including microvascular free tissue transfer, for repair of large full-thickness scalp defects. The procedure has excellent results and can be performed under sedation and local anesthesia, which avoids the risks associated with general anesthesia.4. |
| Databáze: | OpenAIRE |
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