Specialty Doctor in OMS, Ashford Hospital, Ashford.
Specialty Doctor in OMS, Ashford Hospital, Ashford.
J Oral Maxillofac Surg. 2024 Mar;82(3):341-346. doi: 10.1016/j.joms.2023.11.016. Epub 2023 Nov 25.
Large-defect reconstructive surgeries for skin cancer can be performed using different approaches. Integra Dermal Regeneration Template (DRT, Integra Life Sciences, Princeton, New Jersey, the United States) is a membrane utilized to fill skin defects, followed by second-stage surgery with a full-thickness skin graft or flap.
To evaluate the frequency of success of the single-stage scalp reconstructive surgeries using the DRT membrane without second-stage surgery and its feasibility in practice.
STUDY DESIGN, SETTING, AND SAMPLE: This retrospective case series study was conducted to investigate the outcomes of patients with skin cancer scalp defects, reconstructed using DRT, from June 2019 to June 2022, in the Oral and Maxillofacial Department at Ashford and St. Peter's Hospitals, United Kingdom. The patients who underwent further surgery were excluded.
Not applicable.
This study aimed to evaluate the achievement of complete re-epithelialization solely using the DRT membrane along with appropriate dressing management, scored as a "yes" or "no."
Patient's age, defect size, timing of bolster, DRT silicone layer, and dressing removal; anticoagulation, antibiotics, complications, and appointments until complete healing.
Descriptive statistics were computed for each variable.
Forty patients were included in this study and 90% re-epithelialized without complications. Two cases of infection and three bleeding events were recorded. The mean patients' age was 81.5 ± 7.7 years, and the average defect size was 14.7 ± 10 cm. The bolster and silicone layers were removed at 9.1 ± 3.2 and 29.2 ± 12.9 days, respectively. The average number of appointments until healing was 7.8 ± 4.8. Healing time was 3.8 ± 2.1 months, frequency of failure was 10, and 40% received antibiotics.
In our experience, the DRT membrane can be used as a successful single-stage approach in minimizing the need for further surgery. Further studies are needed.
皮肤癌的大缺损重建手术可以采用不同的方法进行。Integra 真皮再生模板（DRT，美国新泽西州普林斯顿 Integra 生命科学公司）是一种用于填充皮肤缺损的膜，随后进行第二期手术，采用全厚皮片或皮瓣。
评估不进行第二期手术而使用 DRT 膜进行单阶段头皮重建手术的成功率及其在实践中的可行性。
研究设计、地点和样本：这是一项回顾性病例系列研究，调查了 2019 年 6 月至 2022 年 6 月期间在英国阿什福德和圣彼得医院口腔颌面外科接受 DRT 治疗的皮肤癌头皮缺损患者的治疗结果。排除了需要进一步手术的患者。
不适用。
本研究旨在评估仅使用 DRT 膜和适当的敷料管理来实现完全再上皮化的效果，评分“是”或“否”。
患者年龄、缺损大小、支撑物时间、DRT 硅胶层和敷料去除时间；抗凝、抗生素、并发症以及直到完全愈合的预约。
对每个变量进行描述性统计。
本研究纳入了 40 名患者，其中 90%的患者无并发症实现了再上皮化。记录了 2 例感染和 3 例出血事件。患者平均年龄为 81.5±7.7 岁，平均缺损面积为 14.7±10cm。支撑物和硅胶层分别在 9.1±3.2 和 29.2±12.9 天后去除。平均愈合预约次数为 7.8±4.8 次。愈合时间为 3.8±2.1 个月，失败率为 10%，40%的患者接受了抗生素治疗。
根据我们的经验，DRT 膜可以作为一种成功的单阶段方法，最大限度地减少对进一步手术的需求。需要进一步的研究。
