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Improved patient‐centered care with effective use of Integra® in dermatologic reconstructive surgery
Author(s) -
Müller Cornelia Sigrid Lissi,
Schiekofer Claudia,
Körner Rebecca,
Pföhler Claudia,
Vogt Thomas
Publication year - 2013
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12038
Subject(s) - medicine , skin cancer , basal cell carcinoma , basal cell , surgery , dermatology , cheek , dermatologic surgery , merkel cell carcinoma , melanoma , scars , cancer , carcinoma , pathology , cancer research
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 cm 2 . 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.