Reconstruction of full thickness scalp defects after tumour excision in elderly patients: Our experience with Integra® dermal regeneration template

Corradino, Bartolo; Lorenzo, Sara Di; Barone, Angelo A. Leto; Maresi, E; Moschella, Francesco

doi:10.1016/j.bjps.2009.05.038

Cited by 66 publications

(43 citation statements)

References 2 publications

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“…The collagen dermal replacement layer serves as a matrix for the infiltration of fibroblasts, macrophages, lymphocytes, and capillaries derived from the wound bed 8 . Routine burring of the calvarium is not performed and vascularization is assumed to occur via infiltration of cells from the wound periphery 6, 9 . A skin graft can then be placed over the collagen matt in a second procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, several other groups have published on the utility of this technique 6, 9 . INTEGRA® allows uncomplicated repair of full thickness scalp defects and has distinct advantages over flap coverage.…”

Section: Discussionmentioning

confidence: 99%

“…The dermal matt confers distinct advantages over flap alternatives for full-thickness scalp defects. These include ease of use, shorter operative times, and decreased donor site morbidity 2, 6 .…”

Section: Introductionmentioning

confidence: 99%

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The Role of Full-Thickness Scalp Resection for Management of Primary Scalp Melanoma

Pannucci¹,

Collar²,

Johnson³

et al. 2012

Annals of Plastic Surgery

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BACKGROUND Scalp melanoma is aggressive and has a proclivity for regional metastasis. We hypothesize that subperiosteal scalp melanoma resection reduces in-transit/satellite recurrence, when compared to subgaleal resection. METHODS We identified patients with intermediate to deep, primary scalp melanoma referred to head/neck surgery over an eight-year period. Patients were compared based on scalp resection depth, including subperiosteal (resection to the level of calvarium) and subgaleal (resection including skin, subcutaneous tissue, and galea). The dependent variables were in-transit/satellite recurrence and time to in-transit/satellite recurrence. RESULTS Among 48 identified patients, the in-transit/satellite recurrence rate was 16.7%. Subgaleal resection patients had higher in-transit/satellite recurrence rates than subperiosteal resection patients (24.0% vs. 8.7%, p=0.155). Among node-negative patients, subgaleal resection had significantly higher in-transit/satellite metastasis rates when compared to subperiosteal resection (26.3% vs. 0%, p=0.047). CONCLUSION For node-negative, primary scalp melanoma, subperiosteal resection significantly decreases in-transit/satellite recurrence when compared to subgaleal resection. Given our small sample size, further studies are necessary to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Role of Full-Thickness Scalp Resection for Management of Primary Scalp Melanoma

Pannucci¹,

Collar²,

Johnson³

et al. 2012

Annals of Plastic Surgery

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“…Skin grafts, alone or after the placement of a dermal substitute, allow for better tumor observation, offer a rapid coverage of the wound, and low morbidity [4]. A major limitation is that split-thickness skin grafts and dermal substitutes need a well vascularized recipient bed to survive because of their high metabolism [5,6]. If the periosteum is absent the vascularization of the underlying intact calvarium is insufficient to allow graft survival.…”

Section: Discussionmentioning

confidence: 99%

Dermal Substitute for Reconstruction of Large Full Thickness Scalp Defect: a Case of Dermal Regeneration without Removal of the Outer Table of the Skull

Monari¹,

Moro²,

Marocolo³

et al. 2017

ARC Journal of Surgery

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“…Surgical options, such as grafting and skin substitutes [1,2], are limited due to the minimal vascularization of the bone surface and therefore usually require removal or drilling holes in the tabula externa [3]. These procedures offer fast solutions, but usually require the patients to be able to undergo anesthesia.…”

Section: Introductionmentioning

confidence: 99%

A Plant-Derived Wound Therapeutic for Cost-Effective Treatment of Post-Surgical Scalp Wounds with Exposed Bone

et al. 2014

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Background: To evaluate efficacy and cost-effectiveness of a plant-derived wound dressing (ONE), a mixture of hypericum oil (Hypericum perforatum L.) and neem oil (Azadirachta indica A. Juss.), in scalp wounds with exposed bone. Patients and Methods: All patients with scalp wounds with exposed bone, following the excision of skin tumors, and treated with ONE in 2011 were included. Time of healing, wound size, area of exposed bone, ease of handling, pain, and complications were evaluated. Costs of dressings and nursing time were compared with those cited in literature for other treatment modalities. Results: Fifteen consecutive patients with a mean age of 76.87 ± 10.3 years (59-90 years) were analyzed. The mean wound size was 10.9 ± 6.84 cm² (0.4-22.6 cm²) with 4.8 ± 5.9 cm² (0.3-20.7 cm²) of exposed bone. The time of complete healing by secondary intention was 8.1 (4-20) weeks. Rapid formation of granulation tissue was observed which after 4 weeks covered the entire exposed bone surface in 11 of 15 cases (73%). Dressing change was simple with no pain reported; no infections or other complications occurred. Using ONE for a mean healing time of 56.7 days resulted in mean costs of EUR 423.73, which is substantially lower than those published for fascia lata, negative pressure therapy, or collagen matrix followed by skin grafting (EUR 1,612.82, EUR 4,411.80 and EUR 1,503.72, respectively). Conclusion: This retrospective, non-controlled analysis supports ONE as a simple-to-use and safe treatment option for scalp wounds with exposed bone. Treatment costs compare favorably to those published for other treatment modalities.

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Reconstruction of full thickness scalp defects after tumour excision in elderly patients: Our experience with Integra® dermal regeneration template

Cited by 66 publications

References 2 publications

The Role of Full-Thickness Scalp Resection for Management of Primary Scalp Melanoma

The Role of Full-Thickness Scalp Resection for Management of Primary Scalp Melanoma

Dermal Substitute for Reconstruction of Large Full Thickness Scalp Defect: a Case of Dermal Regeneration without Removal of the Outer Table of the Skull

A Plant-Derived Wound Therapeutic for Cost-Effective Treatment of Post-Surgical Scalp Wounds with Exposed Bone

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