Grassi Davide, De Monti Marco, Espeli Vittoria, De Pellegrin Laura
EOC - Mendrisio Beata Vergine Regional Hospital - Department of General Surgery, Switzerland.
EOC - Mendrisio Beata Vergine Regional Hospital - Department of General Surgery, Switzerland.
Int J Surg Case Rep. 2024 Feb;115:109208. doi: 10.1016/j.ijscr.2023.109208. Epub 2023 Dec 30.
Dermal Regeneration Templates may be used in the reconstruction of large skin defects after cutaneous malignancy excisions. Bowen's disease (BD; squamous cell carcinoma in situ) is a common and persistent condition that can be related to chronic sun damage, and consequently, is usually located on the head and neck area or on the lower limbs. Literature does not provide clear guidelines on the treatment of BD, limiting itself to describing a wide range of different methods that can be used, including surgery, laser therapy or topical options. However, large lesions tend to scar in the post-operative setting and hence are difficult to treat surgically.
In this paper the authors present a case of a male in his 60s, ASA III score, who presented with a history of histopathologically-confirmed squamocellular carcinoma in the neck and supraclavicular region. Due to recurrent carcinomas the patient was treated with an extensive skin excision and a successful reconstruction using a Dermal Regeneration Template. The work has been reported in line with the SCARE criteria.
The main surgical problem caused by BD is reaching complete oncological resection and, consequently, the need for extensive skin excisions.
The use of the skin substitute resulted in a satisfactory functional and aesthetic result, with total clearance and no recurrence observed after 16 months.
真皮再生模板可用于皮肤恶性肿瘤切除术后大面积皮肤缺损的重建。鲍恩病(BD;原位鳞状细胞癌)是一种常见且持续存在的疾病,可能与慢性阳光损伤有关,因此通常位于头颈部或下肢。文献中没有提供关于BD治疗的明确指南,仅局限于描述一系列可使用的不同方法,包括手术、激光治疗或局部治疗方案。然而,大的病变在术后往往会留下疤痕,因此手术治疗困难。
本文作者介绍了一例60多岁、美国麻醉医师协会(ASA)Ⅲ级评分的男性患者,其颈部和锁骨上区域有组织病理学确诊的鳞状细胞癌病史。由于复发性癌,患者接受了广泛的皮肤切除,并使用真皮再生模板成功进行了重建。该病例报告符合SCARE标准。
BD引起的主要手术问题是实现彻底的肿瘤切除,因此需要广泛的皮肤切除。
使用皮肤替代物取得了令人满意的功能和美学效果,实现了完全清除,16个月后未观察到复发。