The use of a dermal substitute for simultaneous flap delay and donor site coverage in two cases

Abstract

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Use of the sternocleidomastoid flap in association with a dermal regeneration template and a skin graft in the temporal region reconstruction

“…Considering surgical site depth, and to avoid a postsurgical excessive scar retraction, the muscle was covered with Integra ® Dermal Regeneration Template single layer and a skin graft was harvested from the left thigh. As stated in the literature, dermal regeneration templates can be successfully used over flap muscles and in combination with skin grafts [7], [8], [9]. We do think that, in these patients presenting high comorbidities, this two-step technique was perfectly adapted.…”

Dermal Substitutes in the Setting of Flap Delay: A Reconstructive Technique to Enhance Flap Viability

“…Integra itself is a bilaminate DS in which the dermal layer is composed of bovine collagen and chondroitin-6-sulfate glycosaminoglycan and an epidermal layer of synthetic silicone. 2 Recently, Behar et al, 3 described the novel and successful application of a DS (Integra) combined with the delayed flap technique in two separate cases for the reconstruction of lower extremity traumatic wounds. Flap delay is a common surgical technique that is used to enhance the vascular supply to a flap to improve flap survival.…”

“…Concomitant use of both the delayed flap technique and a bilaminate DS (Integra) has been reported in only one other published article, 3 but never for the coverage of a cutaneous malignancy excision wound. Both the delayed flap technique and double layer DS provide numerous and distinct benefits to wound treatment.…”

“…It is posited that the use of a DS underneath the dissected flap may decrease the risk of infection, as well as inhibit revascularization of the flap, during the interval period. 3 Both effects may lead to increased flap viability. It is important to note that because both the delayed flap technique and the use of a DS require two sequential surgeries, they fit nicely together in the treatment course.…”