Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France.
Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France; Department of Maxillo-facial Surgery and Stomatology, Pitié-Salpétrière Hospital, Pierre et Marie Curie University Paris 6, Sorbonne Paris Cite University, AP-HP, 75013 Paris, France; Head and Neck Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France.
J Stomatol Oral Maxillofac Surg. 2021 Jun;122(3):256-262. doi: 10.1016/j.jormas.2020.06.016. Epub 2020 Jul 3.
The aim of the study is the use of Integra® dermal regeneration template (DRT) in scalp reconstruction after tumor resection by comparing results of literature and Gustave Roussy Institut' series of 20 patients.
A systematic review, with a PubMed search was performed using the following key words "artificial dermis OR DRT" AND "scalp". Eligible articles were selected to study patients and defects characteristics, operative modalities, and the follow up results. This case series presents the experience of immediate DRT reconstruction after scalp full thickness carcinologic surgery, in the plastic surgery service of Gustave Roussy cancer center.
Twenty patients with primary scalp tumors underwent two steps DRT reconstruction for full thickness scalp defect. The mean surface defect was 72cm. The mean operative combined time was 94min, with a total healing delay of 68 days. All patients successfully recovered. Five patients had minor complications (3 delayed healing and 2 DRT infections) with no need of additional surgery. Fourteen articles, totalizing n=210 patients, were included and reviewed. Reported ages ranged from 58 to 82 years old. Almost all patients were operated for oncologic resections. The mean surface defect was 73cm. The mean follow-up was 15 months. The skin graft taking rates ranged from 95% up to 100%.
In large scalp full thickness defects after cancer resection, DRT appears to be a suitable reconstruction option for patients with comorbidities, and aggressive tumors. This technique allows immediate coverage of the calvarium with short operative time and prevents from healing delay. The oncologic follow-up is no disturbed and cancer recurrences are easily diagnosed.
本研究旨在通过比较文献和 Gustave Roussy 研究所 20 例患者系列的结果,使用 Integra®真皮再生模板(DRT)进行头皮肿瘤切除后的重建。
进行了系统评价,通过 PubMed 搜索使用了以下关键词“人工真皮 OR DRT”和“头皮”。选择符合条件的文章来研究患者和缺陷特征、手术方式以及随访结果。本病例系列介绍了 Gustave Roussy 癌症中心整形外科服务中立即进行 DRT 重建头皮全层癌性手术后的经验。
20 例原发性头皮肿瘤患者行两阶段 DRT 重建全层头皮缺损。平均表面缺损为 72cm。平均手术联合时间为 94 分钟,总愈合延迟 68 天。所有患者均成功康复。5 例患者出现轻微并发症(3 例延迟愈合,2 例 DRT 感染),无需额外手术。纳入并回顾了 14 篇文章,共 210 例患者。报告的年龄范围为 58 至 82 岁。几乎所有患者均因肿瘤切除术而接受手术。平均表面缺损为 73cm。平均随访时间为 15 个月。植皮成活率为 95%至 100%。
在癌症切除后全层头皮大缺损中,DRT 似乎是合并症和侵袭性肿瘤患者的合适重建选择。该技术可立即覆盖颅骨,手术时间短,可防止愈合延迟。肿瘤学随访不受干扰,癌症复发易于诊断。