Integra as Firstline Treatment for Scalp Reconstruction in Elderly Patients

Mogedas-Vegara, Alfonso; Agut-Busquet, Eugènia; Marsal, Mireia Yébenes; Aguilar, Jesús Luelmo; Torre, Òscar Escuder de la

doi:10.1016/j.joms.2021.07.009

Cited by 5 publications

(9 citation statements)

References 32 publications

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“…As with any surgery, the complications must be carefully considered. In a retrospective cohort study of over 50 patients undergoing scalp reconstruction, the complications reported included infection, hematoma, and seroma 4 . The graft infection rate causing partial or total Integra™ graft loss was reported as 18.6%.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective cohort study of over 50 patients undergoing scalp reconstruction, the complications reported included infection, hematoma, and seroma. 4 The graft infection rate causing partial or total Integra™ graft loss was reported as 18.6%. In a 2016 systematic review of literature focused on Integra™ based scalp reconstruction, infection was the number one complication.…”

Section: Discussionmentioning

confidence: 99%

“…If postoperative radiotherapy is indicated, this may pose an additional consideration for a robust vascular tissue closure over the tissue in question. If radiotherapy is considered, rotational scalp flaps or free tissue options may provide the best options for coverage of the primary site especially over exposed bone or pericranium which alone or with a skin graft, may not withstand radiotherapy without secondary postradiation wound sequelae 4 . If radiotherapy is not indicated, more conservative options may be explored to repair the primary site based on patient tolerance and preoperative discussion.…”

Section: Introductionmentioning

confidence: 99%

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Delayed skin grafting protocol following Integra™ application for non‐radiated scalp reconstruction for decreased wound depth and improved contour

Reece,

Walker,

Benintendi

et al. 2023

Head & Neck

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The clinical use of Integra™ has expanded to include scalp reconstruction since its FDA approval in 1996. Integra™, or dermal regeneration template, can be utilized in patients who are elderly with multiple medical comorbidities. Well‐established Integra™ techniques utilize skin grafting 1–2 weeks following evidence of template vascularity. Most studies show the time to graft placement as <30 days, with almost all <52 days. No single article proposes a time frame for applying STSG after neodermis regeneration. Therefore, we aimed to describe our protocol to define a time frame for delaying scalp reconstruction with STSG following dermal regeneration. Over the last several years, the senior author has utilized a delayed reconstruction with skin grafting method where‐in Integra™ is applied to either debrided bone or exposed pericranium in selected patients, and allowed to mature for ~6 weeks before performing skin grafting. The results have been predictable, reproducible, and have yielded high levels of patient and provider satisfaction due to the improved contour cosmesis. In this pictorial essay, the authors' novel protocol is detailed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delayed skin grafting protocol following Integra™ application for non‐radiated scalp reconstruction for decreased wound depth and improved contour

Reece,

Walker,

Benintendi

et al. 2023

Head & Neck

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show abstract

“…The emerging use of Integra ® as an adjunct or alternative to skin grafting offers potential solutions to the many challenges in scalp reconstruction, as well as a unique approach to the reconstruction of full thickness defects [ 4 ]. Multiple studies have demonstrated the effectiveness of Integra ® in scalp reconstruction [ 4 , 5 , 6 ], as well as its expanding applications in various anatomical locations. The current literature indicates favourable outcomes and low complication rates associated with the use of Integra ® across different surgical specialties [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies have demonstrated the effectiveness of Integra ® in scalp reconstruction [ 4 , 5 , 6 ], as well as its expanding applications in various anatomical locations. The current literature indicates favourable outcomes and low complication rates associated with the use of Integra ® across different surgical specialties [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Integra® Dermal Regeneration Template in Complex Scalp Reconstruction

Turton,

Aggarwal,

Twohig

et al. 2024

JCM

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Background/Objectives: The need for surgical reconstruction of scalp defects following the excision of cutaneous skin cancers is an increasingly common procedure. Particular challenges arise when considering options for reconstruction of large defects not amenable to local skin flap coverage. The use of skin grafts poses the risk of donor site morbidity. This paper investigates the emerging use of Integra®, a synthetic acellular dermal regeneration template, as an alternative or adjunct to skin grafting in scalp reconstruction. Methods: The study presents a retrospective analysis of 101 patients who underwent Integra®-based reconstruction of scalp defects. Demographics, procedure details, complications, need for further surgery, and time to healing were evaluated. Results: The overall success rate of the one-stage Integra®-only procedure was 95%, with a minor complication rate of 30.7%. Anticoagulation medication was identified as an independent risk factor for post-operative infection, while previous head and neck radiotherapy and increased defect depth were associated with the requirement for a second-stage skin graft. Conclusions: These findings support the consideration of Integra® as a safe and viable alternative for both partial and full thickness scalp defects in a select cohort of complex highly co-morbid patients, reducing complications and the need for additional procedures.

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Unusual cell-cell cooperative mechanical activity elucidates the process of tissue regeneration

V Yannas

2024

Journal of Biomechanics

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Integra as Firstline Treatment for Scalp Reconstruction in Elderly Patients

Cited by 5 publications

References 32 publications

Delayed skin grafting protocol following Integra™ application for non‐radiated scalp reconstruction for decreased wound depth and improved contour

Delayed skin grafting protocol following Integra™ application for non‐radiated scalp reconstruction for decreased wound depth and improved contour

Integra® Dermal Regeneration Template in Complex Scalp Reconstruction

Unusual cell-cell cooperative mechanical activity elucidates the process of tissue regeneration

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