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真皮再生模板在皮肤肿瘤重建手术中的应用:一项为期两年的回顾性研究。

Integra Dermal Regeneration Template in reconstructive surgery for cutaneous tumours: a two-year retrospective review.

机构信息

German Hospital, 1640 Pueyrredón Avenue, Buenos Aires City, C1118 AAT, Argentina.

Integra LifeSciences, 1100 Campus Road, Princeton, NJ 08540, US.

出版信息

J Wound Care. 2022 Jul 2;31(7):612-619. doi: 10.12968/jowc.2022.31.7.612.

Abstract

OBJECTIVE

Integra Dermal Regeneration Template (IDRT) (Integra LifeSciences, US) is a bioengineered dermal matrix that has been widely used in burn reconstruction since its first description. However, little is reported on its use in oncologic dermatological defects. Our objective was to evaluate reconstruction using IDRT on cutaneous tumour defects.

METHOD

We conducted a two-year retrospective review of patients with skin tumours who had an excision surgery, followed by reconstruction with IDRT, as a mid-step towards a final autograft procedure: a split-thickness skin graft. The records of all patients at a single academic institution were queried from the electronic medical record using data obtained from the operating surgeon.

RESULTS

We identified 13 patients with different tumour types and locations. The mean defect size was 105.92cm². The matrix take rate was 92.3% and average postoperative day for definite autograft was 20 days. Patients were followed for a period of up to 12 months. Of the patients, one had exposed bone without periosteum; another patient showed recurrence six months after matrix placement, requiring a new second two-stage IDRT-autograft procedure before radiation therapy. Patients reported complete satisfaction with the cosmetic, functional and oncological results. No cases of infection were encountered.

CONCLUSION

IDRT is a valid option for the reconstruction of oncologic surgical defects of the skin and can be used in different anatomical locations. Specifically, it is an alternative to the reconstructive ladder when grafts and local flaps are not possible in those patients, and an option for patients who will eventually need adjuvant radiotherapy.

摘要

目的

Integra 真皮再生模板(IDRT)(Integra LifeSciences,美国)是一种生物工程真皮基质,自首次描述以来,已广泛用于烧伤重建。然而,关于其在肿瘤皮肤科缺陷中的应用报道甚少。我们的目的是评估使用 IDRT 对皮肤肿瘤缺损的重建效果。

方法

我们对在一家学术机构接受过肿瘤切除术、随后使用 IDRT 进行重建的患者进行了为期两年的回顾性研究,以期最终进行自体移植物(即皮肤移植)手术。使用从手术医生那里获得的数据,通过电子病历从电子病历中查询所有患者的记录。

结果

我们共确定了 13 名患有不同肿瘤类型和部位的患者。平均缺损大小为 105.92cm²。基质覆盖率为 92.3%,明确进行自体移植的平均术后天数为 20 天。患者的随访时间最长为 12 个月。其中一名患者有暴露的无骨膜的骨头,另一名患者在基质放置六个月后出现复发,需要在放射治疗前进行新的第二次 IDRT-自体移植手术。患者对美容、功能和肿瘤学结果完全满意。未发生感染病例。

结论

IDRT 是一种治疗皮肤肿瘤外科缺损的有效选择,可用于不同的解剖部位。具体来说,对于那些无法进行移植物和局部皮瓣的患者,它是重建阶梯的替代方案,对于那些最终需要辅助放疗的患者也是一种选择。

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