scholarly journals 803 Management of An Intra-Oral Resection with Integra® Dermal Regeneration Template – Worth A Bite?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E McParland ◽  
R Dua ◽  
G Smith
Keyword(s):  
Oral Cancer ◽  
Donor Site ◽  
Cover Plate ◽  
Severe Dysplasia ◽  
Specific Patient ◽  
Donor Site Pain ◽  
Wound Matrix ◽  
Dermal Regeneration Template ◽  
Gag Reflex ◽  
Dermal Regeneration

Abstract Introduction There are a spectrum of treatment options available for reconstruction of oral mucosal defects including secondary healing, skin grafts, local flaps and microvascular free flaps. We present the use of an alternative intra-oral reconstruction with Integra® Dermal Regeneration Template. Case Report An 85-year-old patient with a severe gag reflex and history of oral cancer presented with biopsy proven severe dysplasia of the right palate extending to the hamular notch. She was treated with wide local excision, extraction of teeth, buccal fat pad advancement for closure of an oral-antral communication and placement of Integra® Dermal Regeneration Template. Discharge was possible the same day as the patient was able to eat and had minimal pain. Discussion Integra® Dermal Regeneration Template is a bilayer wound matrix consisting of silicone in the outer layer with bovine collagen and glycosaminoglycan from shark cartilage in the inner layer. Oral cancer predominantly affects the older population, and this method can reduce surgical time, remove donor site pain, reduce post-operative pain and avoid use of a cover plate where a strong gag reflex was present. The area heals quickly and aids quick restoration of oral function. Conclusion Integra® Dermal Regeneration Template has been used for head and neck defects with good outcomes. It is being increasingly used intra-orally with good outcomes, suggesting a further application of the material with advantages over traditional techniques in specific patient groups.

Treating Giant Congenital Nevus With Integra Dermal Regeneration Template in a 9-Year-Old Girl

2017 ◽  
Vol 16 (2) ◽  
pp. 143-145 ◽  
Author(s):  
Zoran Barcot ◽  
Dakovic Bacalja Inga ◽  
Bozidar Zupancic ◽  
Vedran Bacalja
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Skin Layer ◽  
Congenital Nevus ◽  
Thickness Skin ◽  
Increased Risk ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration ◽  
Split Skin ◽  
Giant Congenital Nevus

Integra dermal regeneration template has been well established in treating deep extensive burns, but there are very few cases reported of treating large full-thickness skin defects such as giant nevi. Apart from psychological and cosmetic burdens, the giant congenital nevus carries increased risk of malignant alteration. We present the case of a 9-year-old girl with a giant congenital nevus on her left lower leg. A total excision was done and she was successfully treated with Integra (LifeSciences Corp, Plainsboro, NJ). Three weeks later, a thin split-skin graft was applied over the neodermal skin layer. The takeoff was 91%. Protected with the silver wound dressing, the rest of the wound healed. A donor site morbidity was minimal, and the final result was excellent both in aesthetic and functional aspects.

The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

2013 ◽  
Vol 154 (6) ◽  
pp. 225-227 ◽  
Author(s):  
Csaba Halmy ◽  
Zoltán Nádai ◽  
Krisztián Csőre ◽  
Adrienne Vajda ◽  
Róbert Tamás
Keyword(s):  
Surgical Treatment ◽  
Skin Lesion ◽  
Surgical Management ◽  
Skin Grafting ◽  
Skin Tumor ◽  
Temporal Region ◽  
Aesthetic Result ◽  
Malignant Skin ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

31 A phase 3 open-label, controlled, randomized trial evaluating the efficacy and safety of a bioengineered allogeneic cellularized construct in patients with deep partial-thickness thermal burns

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S25-S26
Author(s):  
Angela L F Gibson ◽  
James H Holmes ◽  
Jeffrey W Shupp ◽  
David Smith ◽  
Victor Joe ◽  
...  
Keyword(s):  
Donor Site ◽  
Efficacy And Safety ◽  
Phase 3 ◽  
Thermal Burns ◽  
Treatment Site ◽  
Severe Burns ◽  
Donor Site Pain ◽  
The Difference ◽  
Percent Area ◽  
Site Pain

Abstract Introduction Autograft (AG) is the standard of care for treatment of severe burns. While AG provides effective wound closure (WC), the procedure creates a donor site wound prone to pain and scarring. In a phase 1b trial, no deep partial-thickness (DPT) wound treated with a bioengineered allogeneic cellularized construct (BACC) required AG by Day 28 and WC at the BACC site was achieved in 93% of patients by Month (M) 3. This phase 3 study (NCT03005106) evaluated the efficacy and safety of this BACC in patients with DPT burns. Methods Enrolled patients were aged ≥18 years with 3–49% TBSA thermal burns on the torso or extremities. In each patient, two DPT areas (≤2,000 cm2 total) deemed comparable following excision were randomized to treatment with either cryopreserved BACC or AG. Coprimary endpoints were 1) the difference in percent area of BACC treatment site and AG treatment site autografted at M3 and 2) the proportion of patients achieving durable WC of the BACC treatment site without AG at M3. Ranked secondary endpoints were: 1) the difference between BACC and AG donor sites in average donor site pain intensity through Day 14; 2) the difference between BACC and AG donor site cosmesis at M3; and 3) the difference between BACC and AG treatment site cosmesis at M12. Safety assessments were performed in all patients through M12. Results Seventy-one patients were enrolled. By M3, there was a 96% reduction in mean percent area of BACC treatment sites that required AG, compared with AG treatment sites (4.3% vs 102.1%, respectively; P<.0001). BACC treatment resulted in durable WC at M3 without AG in 92% (95% CI: 85.6, 98.8; 59/64) of patients for whom data was available. By M3, mean donor site Patient and Observer Scar Assessment Scale (POSAS) observer total score (±SD) was significantly lower (more like normal skin) for BACC donor sites compared with AG donor sites (6.3 ± 1.71 vs 16.3 ± 7.71; P<.0001). At M12, mean POSAS observer total score (±SD) was 15.6 (± 8.34) for BACC treatment sites compared with 16.3 (± 9.41) for AG treatment sites (P=.4268). The most common BACC-related adverse event (AE) was pruritus, which occurred in 11 (15%) patients. All BACC-related AEs were mild or moderate in severity. Conclusions This phase 3 study achieved both coprimary endpoints, including significant autograft sparing and durable WC in DPT burns. Both donor site pain and donor site cosmesis were favorable outcomes of significantly reduced use of AG in BACC-treated patients. M12 POSAS for BACC did not differ significantly from AG. This BACC may offer a new treatment for severe burns to reduce or eliminate the need for AG. Applicability of Research to Practice This BACC has shown clinical benefit in patients with DPT thermal burns, potentially mitigating donor site morbidity. External Funding Stratatech, a Mallinckrodt Company; Funding and technical support for the Phase 3 clinical study were provided by the Biomedical Advanced Research and Development Authority (BARDA), under the Assistant Secretary for Preparedness and Response, within the U.S. Department of Health and Human Services, under Project BioShield Contract No. HHSO100201500027C.

Distal Tibia Bone Graft for Arthrodesis of the Foot and Ankle

1995 ◽  
Vol 16 (4) ◽  
pp. 187-190 ◽  
Author(s):  
Marc B. Danziger ◽  
Richard V. Abdo ◽  
J. Elliot Decker
Keyword(s):  
Bone Graft ◽  
Disease Transmission ◽  
Donor Site ◽  
Distal Tibia ◽  
Iliac Crest Bone Graft ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Foot And Ankle ◽  
Ankle Motion ◽  
Donor Site Pain

Forty patients since 1988 have had distal tibial bone grafting for 41 arthrodeses of the foot and ankle. Bone graft is obtained through a cortical window made just above the medial metaphyseal distal tibial flare. Average follow-up was 23.3 months. Forty of 41 arthrodesis sites fused; there was only one nonunion. There were no delayed unions. There were no complications at the donor site based on patient examination and radiographs. Ipsilateral ankle motion was not affected by the bone graft procedure. Cited complications from iliac crest bone graft include donor site pain, blood loss, heterotopic bone formation, pelvic instability, iliac hernia, infection, fracture, and deformity. Complications with allografts include disease transmission and immune response. These are avoided by using locally obtained distal tibia autograft for arthrodeses in the foot and ankle.

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