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皮肤替代物在皮肤肿瘤重建手术中的应用:单中心经验

Dermal Substitutes Use in Reconstructive Surgery for Skin Tumors: A Single-Center Experience.

作者信息

Campagnari Mariane, Jafelicci Andrea S, Carneiro Helio A, Brechtbühl Eduard R, Bertolli Eduardo, Duprat Neto João P

机构信息

Skin Cancer Department, AC Camargo Cancer Center, São Paulo, SP, Brazil.

Surgical Oncology, AC Camargo Cancer Center, São Paulo, SP, Brazil.

出版信息

Int J Surg Oncol. 2017;2017:9805980. doi: 10.1155/2017/9805980. Epub 2017 Jul 2.

Abstract

Reconstructive surgery following skin tumor resection can be challenging. Treatment options after removing the tumor are skin grafting, local pedicled and axial flaps, or microsurgery for complex and extensive wounds correction. Recently, the use of dermal substitutes has been extended to reconstructive surgery in cutaneous oncology. . To report both a single-center experience using dermal substitutes in reconstructive surgery for skin malignancies and reconstructive surgery's outcomes. . Among thirteen patients, seven (53.8%) were male with mean age of 62.6 years. Regarding diagnosis, there were five cases (38.5%) of basal cell carcinoma (BCC), two (15.4%) of melanoma in situ, two (15.4%) of dermatofibrosarcoma protuberans, one (7.7%) of squamous cell carcinoma (SCC), one (7.7%) of angiosarcoma, and one (7.7%) of eccrine carcinoma (EC). The most common site of injury was scalp (53.8%) and lower limbs (23.1%). Seven (53.8%) patients used NPWT and six (46.2%) patients underwent Brown's dressing. The most frequent complication of the first stage was wound contamination (38.5%). Average time to second-stage skin grafting was 43.9 days. Three (23%) patients developed tumor recurrence and one died. . Use of dermal substitutes in oncology can be an option for reconstruction after extended resections, providing good aesthetical and functional results.

摘要

皮肤肿瘤切除后的重建手术具有挑战性。切除肿瘤后的治疗选择包括皮肤移植、局部带蒂皮瓣和轴型皮瓣,或用于复杂和大面积伤口矫正的显微外科手术。最近,真皮替代物的应用已扩展到皮肤肿瘤学的重建手术中。报告在皮肤恶性肿瘤重建手术中使用真皮替代物的单中心经验以及重建手术的结果。在13例患者中,7例(53.8%)为男性,平均年龄62.6岁。在诊断方面,有5例(38.5%)基底细胞癌(BCC)、2例(15.4%)原位黑色素瘤、2例(15.4%)隆突性皮肤纤维肉瘤、1例(7.7%)鳞状细胞癌(SCC)、1例(7.7%)血管肉瘤和1例(7.7%)汗腺癌(EC)。最常见的损伤部位是头皮(53.8%)和下肢(23.1%)。7例(53.8%)患者使用了负压伤口治疗(NPWT),6例(46.2%)患者采用了布朗氏敷料。第一阶段最常见的并发症是伤口污染(38.5%)。二期皮肤移植的平均时间为43.9天。3例(23%)患者出现肿瘤复发,1例死亡。在肿瘤学中使用真皮替代物可以作为扩大切除术后重建的一种选择,可提供良好的美学和功能效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc0c/5511644/b335cceb28d9/IJSO2017-9805980.001.jpg

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