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《Integra(®) 在癌症重建手术中的应用经验》。

Experience of Integra(®) in cancer reconstructive surgery.

机构信息

Department of Plastic & Reconstructive Surgery, St George's Healthcare NHS Trust, Tooting, London, United Kingdom.

出版信息

J Plast Reconstr Aesthet Surg. 2010 Dec;63(12):2081-90. doi: 10.1016/j.bjps.2010.02.025. Epub 2010 Mar 23.

Abstract

OBJECTIVES

Integra® has already established its role in acute burn injuries and scar management. It can also be used to cover non-vascularised wounds such as exposed bone resulting from trauma or tumour resection. The aim of this series was to review all cases that underwent Integra® reconstruction following cancer excision. In particular we were interested in the use of Integra for day-case and local anaesthetic procedures in cases where excision was required down to bone or tendon.

METHODS

All patients who had Integra reconstruction over a three-year period were prospectively followed. A total of 14 cases were identified for inclusion into the series. In each case patient factors such peripheral vascular disease, age and patient choice meant that traditional methods of reconstruction were not possible. As a result a staged Integra® reconstruction was performed.

RESULTS

The 14 cases comprised 11 (78%) males and 3 (22%) females with the majority being diagnosed with Squamous cell carcinomas, 3 (40%) or Malignant Melanomas, 3 (20%). The most common operative sites were digital (5) and scalp (6) in 72% of the cases. The average graft take was 87%. There were 4 early, 4 delayed and 3 late complications in a total of 8 patients mostly resulting in a delay in healing. In 6/14 patients (43%) there were no complications.

CONCLUSIONS

Tumour excision and wide local excision may leave patients with defects requiring complex reconstructive surgery. The options available are often compounded by various patient factors. In complex cases we have found the use of Integra® to be a safe and viable alternative to traditional methods of wound closure.

摘要

目的

Integra® 在急性烧伤和疤痕管理中已经确立了其地位。它也可用于覆盖因创伤或肿瘤切除而暴露的骨头等非血管化的伤口。本系列的目的是回顾所有接受 Integra® 重建的癌症切除后病例。特别是,我们对 Integra 在需要切除至骨头或肌腱的情况下用于日间手术和局部麻醉程序的用途感兴趣。

方法

在三年内对所有接受 Integra 重建的患者进行前瞻性随访。共确定了 14 例病例纳入该系列。在每例患者中,周围血管疾病、年龄和患者选择等因素意味着传统的重建方法是不可能的。因此,进行了分期 Integra®重建。

结果

14 例患者包括 11 例(78%)男性和 3 例(22%)女性,大多数被诊断为鳞状细胞癌,3 例(40%)或恶性黑色素瘤,3 例(20%)。最常见的手术部位是手指(5 例)和头皮(6 例),占 72%的病例。平均移植物吸收率为 87%。共有 8 例患者中的 4 例发生早期、4 例发生延迟和 3 例发生晚期并发症,导致愈合延迟。在 14 例患者中有 6 例(43%)没有并发症。

结论

肿瘤切除和广泛局部切除可能会使患者留下需要复杂重建手术的缺陷。可供选择的方案往往因各种患者因素而变得复杂。在复杂病例中,我们发现 Integra® 的使用是传统伤口闭合方法的安全可行的替代方案。

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