One-stage scalp reconstruction using single-layer dermal regeneration template and split-thickness skin graft: a case series

Abstract

Purpose Scalp full-thickness defects reconstruction following the resection of skin carcinoma poses significant challenges due to scalp anatomy complexity and limited vascularity. Despite various techniques available, including tissue expansion and local flaps, no single method stands as the gold standard. Moreover, cases requiring adjuvant radiotherapy further complicate reconstruction, demanding durable solutions. This study explores the efficacy of Integra® Dermal Regeneration Template Single Layer (Integra DRTSL) followed by split-thickness skin grafting (STSG) in one-stage scalp reconstruction post oncologic resection. Methods A retrospective analysis was conducted on patients undergoing this procedure from January 2020 to October 2023. Surgical outcomes, including graft take rates, complications, and adjuvant therapy tolerability, were assessed. Results Results demonstrated successful reconstruction in the majority of cases, with a complete graft take rate of 77% and minimal complications. Notably, the single-stage approach facilitated timely initiation of adjuvant therapy, crucial for oncologic management. Healing times were notably reduced (< 60 days), enabling early radiotherapy commencement. No local recurrences were observed during the 16-month follow-up. Conclusion The use of Integra DRTSL with STSG in one-stage reconstruction presents a promising alternative, offering optimal cosmetic and functional outcomes with low complication rates. This approach streamlines the reconstruction process, ensuring timely adjuvant therapy initiation and maximizing patient outcomes, especially in the context of scalp cutaneous tumors requiring radiotherapy. Clinical trial number This research was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of University of Campania “Luigi Vanvitelli” (protocol code N. 0013333, 29 April 2021)