Department of Burns and Plastic Surgery, Manchester University NHS Foundation Trust, Manchester, UK
Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Preston, UK.
BMJ Case Rep. 2022 Nov 11;15(11):e251848. doi: 10.1136/bcr-2022-251848.
Dermatofibrosarcoma protuberans (DFSP) is a rare, locally invasive dermal sarcoma. The management is generally surgical, with wide local excision (WLE) forming the mainstay of treatment. Large abdominal wall defects are most aesthetically reconstructed using pedicled or free flaps; however, these require tumour-free surgical margins, and are off-set by donor site morbidity. We describe an alternative, aesthetic and low-morbidity technique for reconstruction of a subfascial defect following WLE of DFSP in a young woman in her early 20s, using two layers of a novel synthetic dermal matrix (NovoSorbBTM). To our knowledge, a double-layer reconstruction using an artificial dermal matrix has never been described for trunk reconstruction. We found that double-layer biodegradable temporising matrix can restore the inherent thickness and pliability of skin in a partial-thickness abdominal wall defect and offers improved durability and cosmesis compared with skin grafting or indeed single layer skin substitutes alone.
隆突性皮肤纤维肉瘤（DFSP）是一种罕见的局部侵袭性真皮肉瘤。其治疗方法通常为手术，广泛局部切除（WLE）是主要的治疗方法。腹壁大缺损的美学重建通常采用带蒂或游离皮瓣；然而，这些需要无肿瘤的手术切缘，并且会增加供区的发病率。我们描述了一种替代的、美观且低发病率的技术，用于在一名 20 多岁的年轻女性接受 DFSP 的 WLE 后，使用两层新型合成真皮基质（NovoSorbBTM）重建筋膜下缺损。据我们所知，双层人工真皮基质重建从未被描述用于躯干重建。我们发现，双层可生物降解的临时基质可以恢复部分厚度腹壁缺损固有厚度和柔韧性，与植皮或单层真皮替代物相比，具有更好的耐用性和美容效果。
