Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Microsurgery. 2011 Feb;31(2):104-8. doi: 10.1002/micr.20833. Epub 2010 Oct 11.
Autologous skin grafting to the donor site in patients who undergo radial forearm free flap reconstruction (RFFF) is associated with cosmetic and functional morbidity. Integra artificial dermis (Integra Lifesciences, Plainsboro, NJ) is a bovine collagen based dermal substitute that can be used as an alternative to primary autologous skin transplantation of the donor site. We describe a staged reconstruction using Integra followed by ultrathin skin grafting that results in highly aesthetic and functional outcomes for these defects. A retrospective review of 29 patients undergoing extirpative head and neck oncologic resection were examined. Integra graft placement was performed at the time of RFFF harvest followed by autologous split thickness skin grafting at 1 to 5 weeks postoperatively. Healing fully occurred within 4-6 weeks with negligible donor site complications, excellent cosmesis, and minimal scar contracture. Composite reconstruction with Integra artificial dermis offers advantages over traditional methods of coverage for select cases of radial forearm free flap donor site closures.
自体皮片移植到接受游离前臂桡侧皮瓣重建（RFFF）的患者供区会引起美容和功能方面的发病率。Integra 人工真皮（Integra Lifesciences，Plainsboro，NJ）是一种牛胶原为基础的真皮替代物，可作为供区原发性自体皮片移植的替代物。我们描述了一种使用 Integra 进行分阶段重建的方法，随后进行超薄皮肤移植，从而使这些缺损获得高度美观和功能的效果。回顾性分析了 29 例行头颈部肿瘤切除术的患者。在游离桡侧皮瓣采集时进行 Integra 移植物放置，然后在术后 1 至 5 周进行自体中厚皮片移植。4-6 周内完全愈合，供区并发症少，美容效果好，瘢痕挛缩极小。对于桡侧前臂游离皮瓣供区闭合的某些特定病例，复合重建使用 Integra 人工真皮比传统的覆盖方法具有优势。
