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Improved patient-centered care with effective use of Integra® in dermatologic reconstructive surgery

Authors


Correspondence to

Cornelia S. L. Müller, MD

Department of Dermatology

The Saarland University Hospital

Kirrberger Strasse

66421 Homburg/Saar, Germany

E-mail: cornelia.mueller@uks.eu

Summary

Background

The incidence of skin tumors is increasing among elderly patients, and the multi-morbidities which occur in the elderly are a great challenge for dermatologic surgeons. The currently required safety margins for different types of melanomas and non-melanoma skin cancers lead to extensive and profound wounds.

Objective

To investigate the usefulness of a dermal substitute (Integra®) for routine use in surgery for dermatologic tumors.

Patients and Methods

In this retrospective study 20 patients underwent sequential surgeries for skin cancer. Wound closures were performed using Integra® (single layer) and immediate split-thickness skin graft.

Results

Twenty-two tumors (6 malignant melanomas, 10 squamous cell carcinomas, 2 pleomorphic sarcomas, 1 basal cell carcinoma, 2 Merkel cell carcinomas, and 1 trichoblastic carcinoma) were resected. The mean defect size was 41.4 cm2. All transplants were (65–100 %) vital; however, defects in the midface (cheek and infra-orbital area) often healed with esthetically disturbing, dense, pillow-like scars.

Conclusions

With the use of Integra®, the duration of hospitalization was decreased, patients with multi-morbidities were effectively treated, and functionally- and esthetically-satisfactory outcomes were achieved. On the basis of these observations, we discuss points of handling those patients who require rapid and effective surgery and undergo dermatologic surgery using dermal substitutes.

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