Gonzalez Santiago R, Wolter Keith G, Yuen James C
Division of Plastic and Reconstructive Surgery, University of California San Francisco, Calif.
Division of Plastic Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Ark.
Plast Reconstr Surg Glob Open. 2020 Jul 15;8(7):e2869. doi: 10.1097/GOX.0000000000002869. eCollection 2020 Jul.
Dermal regeneration templates such as Integra are effective reconstructive biomaterials used in a variety of soft-tissue defects. Fully understanding the complications associated with their use is paramount to improve outcomes and maximize patient safety. In this study, our purpose is to perform a comprehensive literature review to assess the previously reported infectious complications linked to Integra-based wound closure.
We conducted a systematic review of the literature to identify previous articles indexed in PubMed and Ovid for Integra and its synonymous terms. We used these search terms: [Integra OR (dermal regenerative matrix) OR (dermal regeneration matrix) OR (dermal regenerative template) OR (dermal regeneration template) OR (dermal substitute) OR (skin substitute) OR (artificial skin)] AND infection.
Of the 3508 articles for initial review, 69 reported rates of infection, of which 26 reported ≥1 infection within their cohort. Of these 26 articles, the patients (n = 602) underwent Integra-based reconstruction in 1254 sites and had reported infections in 212 of the sites (16.9%). Among these, we encountered a single report of a fatal case of toxic shock syndrome (TSS) related to the use of Integra in secondary burn reconstruction.
While Integra offers many benefits, surgeons must be aware that infectious complications are not uncommon. As a result, a careful risk-benefit analysis of its use in reconstruction must be performed, and open discussion with the patient preoperatively regarding infection rate is of utmost importance.
像Integra这样的真皮再生模板是用于各种软组织缺损的有效的重建生物材料。充分了解与其使用相关的并发症对于改善治疗效果和最大限度提高患者安全性至关重要。在本研究中，我们的目的是进行全面的文献综述，以评估先前报道的与基于Integra的伤口闭合相关的感染性并发症。
我们对文献进行了系统综述，以识别在PubMed和Ovid中索引的关于Integra及其同义词的先前文章。我们使用了这些搜索词：[Integra或（真皮再生基质）或（真皮再生模板）或（真皮替代物）或（皮肤替代物）或（人造皮肤）]和感染。
在初步审查的3508篇文章中，69篇报道了感染率，其中26篇报道其队列中≥1例感染。在这26篇文章中，患者（n = 602）在1254个部位接受了基于Integra的重建，其中212个部位报告有感染（16.9%）。其中，我们遇到了一份关于在二次烧伤重建中使用Integra导致中毒性休克综合征（TSS）致命病例的单一报告。
虽然Integra有很多益处，但外科医生必须意识到感染性并发症并不罕见。因此，必须对其在重建中的使用进行仔细的风险效益分析，并且术前与患者就感染率进行公开讨论至关重要。
