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Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature
BACKGROUND: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensi...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096526/ https://www.ncbi.nlm.nih.gov/pubmed/27826471 http://dx.doi.org/10.1097/GOX.0000000000001074 |
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author | Johnson, Maxwell B. Wong, Alex K. |
author_facet | Johnson, Maxwell B. Wong, Alex K. |
author_sort | Johnson, Maxwell B. |
collection | PubMed |
description | BACKGROUND: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects. METHODS: A comprehensive systematic review was completed using key search terms, including Integra, dermal regeneration template, bovine collagen, skin substitute, forehead, and scalp. Selected articles reported characteristics of patients and their reconstructions. The primary outcome measures were wound complications and percent graft take. RESULTS: Thirty-four articles were included in this systematic review. Wound sizes ranged from 5.7 to 610 cm(2), with 35.3% of articles reporting a mean defect size >100 cm(2). Thirty-two articles reported mean percent take of skin graft ≥90%. Sixteen articles reported a minor complication. There were no major complications associated with the reconstructions. CONCLUSIONS: There is a substantial evidence base for the use of Integra to reconstruct scalp wounds. To date, the dermal regeneration template is generally reserved for salvage procedures or when the patient cannot tolerate free tissue transfer. Based on the findings of this systematic review and the authors’ clinical experience, Integra can be used to achieve predictable results in large complex scalp defects. |
format | Online Article Text |
id | pubmed-5096526 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-50965262016-11-08 Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature Johnson, Maxwell B. Wong, Alex K. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects. METHODS: A comprehensive systematic review was completed using key search terms, including Integra, dermal regeneration template, bovine collagen, skin substitute, forehead, and scalp. Selected articles reported characteristics of patients and their reconstructions. The primary outcome measures were wound complications and percent graft take. RESULTS: Thirty-four articles were included in this systematic review. Wound sizes ranged from 5.7 to 610 cm(2), with 35.3% of articles reporting a mean defect size >100 cm(2). Thirty-two articles reported mean percent take of skin graft ≥90%. Sixteen articles reported a minor complication. There were no major complications associated with the reconstructions. CONCLUSIONS: There is a substantial evidence base for the use of Integra to reconstruct scalp wounds. To date, the dermal regeneration template is generally reserved for salvage procedures or when the patient cannot tolerate free tissue transfer. Based on the findings of this systematic review and the authors’ clinical experience, Integra can be used to achieve predictable results in large complex scalp defects. Wolters Kluwer Health 2016-10-24 /pmc/articles/PMC5096526/ /pubmed/27826471 http://dx.doi.org/10.1097/GOX.0000000000001074 Text en Copyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Original Article Johnson, Maxwell B. Wong, Alex K. Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title | Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title_full | Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title_fullStr | Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title_full_unstemmed | Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title_short | Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature |
title_sort | integra-based reconstruction of large scalp wounds: a case report and systematic review of the literature |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096526/ https://www.ncbi.nlm.nih.gov/pubmed/27826471 http://dx.doi.org/10.1097/GOX.0000000000001074 |
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