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Reconstructive surgery using an artificial dermis (Integra): results with 39 grafts

Integra was initially developed for the primary coverage of acute burns. It acts as a network for dermal reconstruction. An epidermal graft overlay is necessary after 3 weeks to achieve the in vivo reconstruction of a full-thickness skin equivalent. The quality of the functional and aesthetic result...

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Published in:British journal of plastic surgery 2001-12, Vol.54 (8), p.659-664
Main Authors: Dantzer, Eric, Braye, Fabienne M.
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Language:English
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Braye, Fabienne M.
description Integra was initially developed for the primary coverage of acute burns. It acts as a network for dermal reconstruction. An epidermal graft overlay is necessary after 3 weeks to achieve the in vivo reconstruction of a full-thickness skin equivalent. The quality of the functional and aesthetic results achieved led us to evaluate the potential of Integra in the treatment of burn scars and for general reconstructive surgery. We present a series of 31 patients who underwent Integra grafting for reconstructive surgery at a total of 39 operational sites. The average area grafted per procedure was 267 cm 2. Complications (silicone detachment, failure of the graft, haematoma) were observed in nine cases. The length of follow-up ranged from 0.5 year to 4 years. Two patients (two sites) were lost to follow-up; the final results in the remaining patients were considered to be good in 28 cases, average in six cases and poor in three cases. The disadvantages of using Integra in reconstructive surgery are the necessity of two operations, the risks of infection under the silicone layer, of the silicone becoming detached and of recurrence of contraction. On the other hand, Integra has many advantages including its immediate availability, the availability of large quantities, the simplicity and reliability of the technique, and the pliability and the cosmetic appearance of the resulting cover. In the light of these preliminary results, Integra appears as a new alternative to full-thickness skin grafting, skin expansion and even skin flaps for reconstructive surgery.
doi_str_mv 10.1054/bjps.2001.3684
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It acts as a network for dermal reconstruction. An epidermal graft overlay is necessary after 3 weeks to achieve the in vivo reconstruction of a full-thickness skin equivalent. The quality of the functional and aesthetic results achieved led us to evaluate the potential of Integra in the treatment of burn scars and for general reconstructive surgery. We present a series of 31 patients who underwent Integra grafting for reconstructive surgery at a total of 39 operational sites. The average area grafted per procedure was 267 cm 2. Complications (silicone detachment, failure of the graft, haematoma) were observed in nine cases. The length of follow-up ranged from 0.5 year to 4 years. Two patients (two sites) were lost to follow-up; the final results in the remaining patients were considered to be good in 28 cases, average in six cases and poor in three cases. The disadvantages of using Integra in reconstructive surgery are the necessity of two operations, the risks of infection under the silicone layer, of the silicone becoming detached and of recurrence of contraction. On the other hand, Integra has many advantages including its immediate availability, the availability of large quantities, the simplicity and reliability of the technique, and the pliability and the cosmetic appearance of the resulting cover. 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It acts as a network for dermal reconstruction. An epidermal graft overlay is necessary after 3 weeks to achieve the in vivo reconstruction of a full-thickness skin equivalent. The quality of the functional and aesthetic results achieved led us to evaluate the potential of Integra in the treatment of burn scars and for general reconstructive surgery. We present a series of 31 patients who underwent Integra grafting for reconstructive surgery at a total of 39 operational sites. The average area grafted per procedure was 267 cm 2. Complications (silicone detachment, failure of the graft, haematoma) were observed in nine cases. The length of follow-up ranged from 0.5 year to 4 years. Two patients (two sites) were lost to follow-up; the final results in the remaining patients were considered to be good in 28 cases, average in six cases and poor in three cases. The disadvantages of using Integra in reconstructive surgery are the necessity of two operations, the risks of infection under the silicone layer, of the silicone becoming detached and of recurrence of contraction. On the other hand, Integra has many advantages including its immediate availability, the availability of large quantities, the simplicity and reliability of the technique, and the pliability and the cosmetic appearance of the resulting cover. In the light of these preliminary results, Integra appears as a new alternative to full-thickness skin grafting, skin expansion and even skin flaps for reconstructive surgery.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>artificial dermis</subject><subject>Biological and medical sciences</subject><subject>burn sequelae</subject><subject>Burns</subject><subject>Burns - complications</subject><subject>Burns - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cicatrix - etiology</subject><subject>Cicatrix - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>reconstructive surgery</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Skin plastic surgery</subject><subject>skin substitute</subject><subject>Skin Transplantation - methods</subject><subject>Skin, Artificial</subject><subject>Surgery (general aspects). 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dantzer, Eric</creatorcontrib><creatorcontrib>Braye, Fabienne M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dantzer, Eric</au><au>Braye, Fabienne M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reconstructive surgery using an artificial dermis (Integra): results with 39 grafts</atitle><jtitle>British journal of plastic surgery</jtitle><addtitle>Br J Plast Surg</addtitle><date>2001-12-01</date><risdate>2001</risdate><volume>54</volume><issue>8</issue><spage>659</spage><epage>664</epage><pages>659-664</pages><issn>0007-1226</issn><eissn>1465-3087</eissn><coden>BJPSAZ</coden><abstract>Integra was initially developed for the primary coverage of acute burns. 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subjects Adolescent
Adult
Aged
artificial dermis
Biological and medical sciences
burn sequelae
Burns
Burns - complications
Burns - surgery
Child
Child, Preschool
Cicatrix - etiology
Cicatrix - surgery
Female
Follow-Up Studies
Humans
Infant
Male
Medical sciences
Middle Aged
Postoperative Complications
reconstructive surgery
Reconstructive Surgical Procedures - methods
Skin plastic surgery
skin substitute
Skin Transplantation - methods
Skin, Artificial
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Traumas. Diseases due to physical agents
Treatment Outcome
title Reconstructive surgery using an artificial dermis (Integra): results with 39 grafts
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