scholarly journals Closure of large lumbosacral defect using a combined method of bilateral bipedicle flap with lateral releasing incision and Integra® dermal regeneration template

2021 ◽  
Vol 9 (3) ◽  
pp. 345-351
Author(s):  
Pauline Yap ◽  
Arman Zaharil Mat Saad ◽  
Wan Azman Wan Sulaiman ◽  
Siti Fatimah Noor Mat Johar ◽  
Nurul Syazana Mohamad Shah
Keyword(s):  
Skin Grafting ◽  
Fasciocutaneous Flap ◽  
Neural Tube Closure ◽  
Skin Defect ◽  
Lumbar Region ◽  
Combined Method ◽  
Large Defect ◽  
Secondary Defect ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

BACKGROUND: Myelomeningocele is one of the most complex congenital malformations of the central nervous system. It is one of the most common types of spina bifida which involves a failure of neural tube closure. Reconstruction surgery for myelomeningocele had always been challenging for plastic and neurosurgeons. CLINICAL CASE: We report a case of a new-born with lumbosacral myelomeningocele who received treatment in the Hospital Universiti Sains Malaysia. The myelomeningocele was repaired by the neurosurgery team and subsequently, the child was left with huge lumbosacral skin defect. The large defect was successfully covered by using a combined method of bilateral bipedicle flap with lateral releasing incision and remaining lumbosacral and secondary defect resurfaced using Integra dermal regeneration template (DRT). We used ACTICOAT interfaced negative pressure wound therapy (NPWT) as our main dressing in preparing the wound bed for autologous epidermal graft. The result of our closure technique provides tension free closure. DISCUSSION: We incorporated bilateral bipedicle fasciocutaneous flap technique together with DRT for closure of the lumbosacral defect. The bilateral bipedicle flap with lateral releasing incision served to reduce tension on the skin at bilateral lumbar region. The DRT downsized the lumbosacral defect and NPWT dressing provided an optimal sterile environment in giving time for neodermis generation. The remaining secondary defect were also resurfaced utilizing DRT and autologous skin grafting. CONCLUSIONS: The outcome of surgery demonstrated that the combined use of bilateral bipedicle fasciocutaneous flap with lateral releasing incision and DRT with delayed skin grafting is safe, effective and provide long term stable and supple scar for large, exposed dura defect.

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.

The use of Integra “artificial skin, dermal regeneration template” and the reverse radial forearm fasciocutaneous flap in the primary reconstruction of a septic hand injury

2008 ◽  
Vol 149 (35) ◽  
pp. 1653-1656 ◽  
Author(s):  
Csaba Halmy ◽  
Tamás Hábel ◽  
Pál Pesthy ◽  
Zoltán Nádai ◽  
Zsuzsanna Juhász ◽  
...  
Keyword(s):  
Hand Injury ◽  
Fasciocutaneous Flap ◽  
Artificial Skin ◽  
Primary Reconstruction ◽  
Mesh Graft ◽  
Dermal Regeneration Template ◽  
Radial Forearm ◽  
Dermal Regeneration

Elhanyagolt szeptikus kézsérülés következtében nekrotizált kézháti bőr és extensorapparátus miatt a szerzők reverz radiális lebennyel és egy szervezetbe beépülő, mesterséges bőrrel végeztek rekonstrukciót. Esetbemutatás: Az eset bemutatásával beszámolnak az Integra „mesterséges bőr, irha-újraképződési minta” első hazai alkalmazásáról. Az Integra mesterséges bőr a kézhát radiális lebeny által nem fedett területén, illetve az alkari adóterületen került alkalmazásra. Az Integra beépülését követően a külső szilikonréteget eltávolítva rácsplasztikára került sor. Következtetés: Az adóterületen az Integra 100%-ban, a mesh graft 99%-ban, a kézháton mindkettő 90%-ban tapadt meg, jó funkcionális és esztétikai eredményt biztosítva.

Management of severe hand wounds with integra® dermal regeneration template

2010 ◽  
Vol 36 (3) ◽  
pp. 185-193 ◽  
Author(s):  
R. Weigert ◽  
H. Choughri ◽  
V. Casoli
Keyword(s):  
Clinical Experience ◽  
Free Flap ◽  
Skin Grafting ◽  
Effective Technique ◽  
Flap Coverage ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

We report our experience with the use of Integra® for the management of severe traumatic wounds of the hand. Fifteen patients were treated with follow-up ranging from 10 to 37 months. Wounds were associated with an osseous and/or joint and/or tendon exposure. Following Integra® placement, patients were managed with dressings and subsequent split-thickness skin grafting an average of 26 days later. Integra® was successful in achieving durable, functional and aesthetic definitive coverage in 13 of 15 applications while allowing a satisfying pollicidigital prehension. Regarding our clinical experience, Integra® is an effective technique to deal with severe wounds of the hand with exposed tendon and/or bone and/or joint, even in the absence of paratenon or periosteum. This can potentially lessen the need for local rotational or free flap coverage and should be taken into consideration as a viable alternative in traumatic reconstruction of the hand.

scholarly journals Clinical Applications of Micro-Skin Grafting For Skin Defect Coverage

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Aditya Wardhana ◽  
Muhammad Samiadji
Keyword(s):  
Skin Grafting ◽  
Clinical Applications ◽  
Defect Coverage ◽  
Skin Defect ◽  
Defect Closure ◽  
Large Defect ◽  
Donor Area ◽  
Operative Evaluation ◽  
Patient Refusal

Microskin graft is a technique of skin defect closure using a minimum of STSG donors to cover the large defect. Some considerations were taken, which includes the general status of the patient, donor area morbidity, and patient refusal to act is one of the reasons for the use microskin graft. History STSG failure with previous defect closure and lack of donor area would to bene!t from microskin graft. Case of boy 12 years old with extensive defects in the forearm due to burns. Consideration of the lack of donor area made us deciding to use microskin graft as main option to close the defect. We did one-week post operative evaluation. Epithelialization occurs at day 7, while complete epithelialization occurred at 14th day. Three month during follow-up control, the scar are minimal. We conclude that microskin graft is one technic that can be used in skin defect closure with minimal donor.

The role of Integra dermal regeneration matrix in skin replacement on the upper extremity

2012 ◽  
Vol 153 (34) ◽  
pp. 1351-1355 ◽  
Author(s):  
Csaba Halmy ◽  
Zoltán Nádai ◽  
Gergely Tamás ◽  
Tamás Kassai ◽  
Róbert Tamás
Keyword(s):  
Skin Grafting ◽  
Upper Extremities ◽  
Dermal Regeneration Template ◽  
Skin Replacement ◽  
Male Patients ◽  
Dermal Regeneration ◽  
Skin Coverage ◽  
Complex Wounds ◽  
Grafting Onto

Authors report the application of Integra dermal regeneration matrix in 10 patients in 12 indications (ages 25–74 years, 6 female and 4 male patients). The smallest reconstructed area was 6 cm2, the largest was 500 cm2. Skin coverage was needed on the lower arm in two patients, on the lower arm and the hand in two patients and on the hand in six patients. Skin grafting onto the neodermis was made on days 19–25. The take rate of Integra was equal or higher than 97%, and the take rate of the skin graft was equal or higher than 90%. Integra dermal regeneration template proved to be suitable for the management of complex wounds on the hands and upper extremities. Orv. Hetil., 2012, 153, 1351–1355.

A Case of Large Aplasia Cutis Congenita with Underlying Skull Defect: Effective Surgical Treatment with Integra® Dermal Regeneration Template

2021 ◽  
pp. 1-6
Author(s):  
Andrea Scotti ◽  
Elisa Benanti ◽  
Federica Augelli ◽  
Franz Wilhelm Baruffaldi Preis
Keyword(s):  
Free Flaps ◽  
Bony Defect ◽  
Large Defect ◽  
Aplasia Cutis Congenita ◽  
Rare Congenital Abnormality ◽  
Dermal Regeneration Template ◽  
Congenital Condition ◽  
Dermal Regeneration ◽  
Aplasia Cutis

<b><i>Introduction:</i></b> Aplasia cutis congenita (ACC) is a rare congenital abnormality characterized by the absence of a portion of skin at birth which most commonly involves the scalp and can affect the galea, the pericranium, the bone, and the dura mater. It can be an isolated condition or associated with other disorders. <b><i>Case Report:</i></b> We present a case of ACC with a large defect of the scalp and the underlying bone treated with the use of Integra® Dermal regeneration template. At 5 months of follow-up, the wound is completely healed and the bony defect greatly reduced. Contraction of the area of alopecia was observed. <b><i>Discussion:</i></b> Several surgical and conservative options have been described to treat this congenital condition: advanced dressing, skin graft, local flaps, free flaps, and other methods. In our case, we used Integra® Dermal templates which provide a barrier for infections, promote cellular activity for a rapid vascularization, and improve healing.

Management of large scalp and skull defects in a severe case of Adams-Oliver syndrome

2009 ◽  
Vol 4 (6) ◽  
pp. 523-527 ◽  
Author(s):  
Mostafa El Khashab ◽  
Samuel T. Rhee ◽  
Sean D. Pierce ◽  
Yasmin El Khashab ◽  
Farideh Nejat ◽  
...  
Keyword(s):  
Skin Grafting ◽  
Severe Case ◽  
Skull Defects ◽  
Rare Congenital Disorder ◽  
Threatening Condition ◽  
Dermal Regeneration Template ◽  
Life Threatening ◽  
Dermal Regeneration ◽  
Cutis Aplasia ◽  
Large Skin

Adams-Oliver syndrome is a rare congenital disorder that includes congenital scalp and skull defects, variable degrees of terminal transverse limb anomalies, and cardiac malformations. Cutis aplasia occurring in 75% of patients is a potentially life-threatening condition. Large skin defects that cannot be closed primarily present a management dilemma, and may require skin grafting or flaps, or a combination of both operative and conservative modalities. The authors' experience in management of huge scalp and bone defects with the Integra Dermal Regeneration Template and regular dressing changes showed good scalp repair and no serious complications attributed to this approach.

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