Open AccessArtificial dermis (Matriderm®) followed by skin graft as an option in dermatofibrosarcoma protuberans with complete circumferential and peripheral deep margin assessment
Author(s) -
Bertolli Eduardo,
Campagnari Mariane,
Molina André S,
Macedo Mariana P,
Pinto Clovis AL,
Cunha Isabela W,
Duprat Neto João P
Publication year - 2015
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12157
Subject(s) - dermatofibrosarcoma protuberans , medicine , dermis , surgery , granulation tissue , margin (machine learning) , surgical margin , resection , anatomy , pathology , wound healing , machine learning , computer science
Dermatofibrosarcoma protuberans ( DFSP ) is a locally invasive neoplasia with a pattern of infiltrative growth that leads to extended resections. To avoid unnecessary resections and spare tissues, its treatment requires an adequate assessment of the margins. We present a case where artificial dermis (Matriderm®) was used followed by skin graft for reconstruction. We present a 50‐year‐old woman with a DFSP in the occipital region. She was referred to us after a first surgery with positive margins. A wide local excision with a 2‐cm margin was performed and periosteal tissue was also removed, which led to exposure of the skull. Matriderm was placed on the bone surface and dressings were changed every other day. Meanwhile, margins were evaluated by the complete circumferential and peripheral deep margin assessment ( CCPDMA ) and were positive for DFSP in the superior margin. After 4 weeks the area was completely covered by granulation tissue and a new resection followed by reconstruction with a skin graft was performed. With regard to the difficulties in the margin assessment in DFSP , we present artificial dermis (Matriderm) as an option for reconstructive surgery in these patients, especially when a skin graft cannot be performed as a first option.