Reconstructive Surgery with Integra Dermal Regeneration Template: Histologic Study, Clinical Evaluation, and Current Practice

Abstract

The color of the matrix reflected the stage of neodermal vascularization. No adnexa, nerve endings, or elastic fibers were seen in any of the specimens. The new collagen was histologically indistinguishable from normal dermal collagen. The authors also present their current protocol and experience with using Integra for a range of reconstructive procedures.

Microsurgical arterovenous loops and biological templates: A novel in vivo chamber for tissue engineering

“…Since its introduction in clinical practice as primary coverage for major burns after necrectomy, its clinical applications have largely widened to soft tissue deficits after scar excision, contracture release, excision of tight, painful or keloid scars, anesthetic scars, and reconstruction after large excisions (such as in giant naevi, coverage of posttraumatic defects, flap donor site coverage, resurfacing of free flaps, and deep loss of tissue after bone and joint exposure). 18 In our model, the collagen-GAG scaffold acts as a good matrix for new tissue regeneration, allowing the growth of newly formed soft connective tissue into the chamber. Indeed, its properties to direct the ingrowth of soft-connective tissue are well known in the case of dermal regeneration, also thanks to the size and number of its pores.…”

The Crucial Role of Vascularization and Lymphangiogenesis in Skin Reconstruction

“…The integration of a dermal substitute is characterized by four phases: (1) imbibition, (2) fibroblast migration, (3) neovascularization, and finally, (4) remodeling [48]. When applied on bradytrophic tissues, dermal substitutes are predominantly revascularized from the periphery.…”

Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

“…[12][13][14] With the increase in patients, many techniques such as delayed primary closure, dermal substitutes and/or extracellular matrices, skin grafting and spray skin technology, regenerative medicine techniques, mesenchymal and adipose-derived stem cell therapies, nerve allografts, external tissue expanders, and the use of multiple rotational and/or free tissue transfers separately or in combination have proved effective in treatment of complex extremity injuries (Fig. 4).…”

“…4). [12][13][14][15][16] Surgeons choose flaps based on wound geometry and the location of vital structures such as blood vessels, nerves, and bone within the wound as well as attempt to maximize the function of the salvaged limb. [17][18][19] Nonmilitary surgeons can apply these findings to the practice of civilian trauma.…”