Human Cadaveric Dermal Matrix for Management of Challenging Surgical Defects on the Scalp

BACKGROUND Biologic scaffolds have shown promise in patients unable to tolerate prolonged surgical closure or extensive wound care, but there has been little research in the field of Mohs micrographic surgery (MMS) on human cadaveric dermis in this capacity. OBJECTIVE To evaluate the utility of huma...

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Bibliographic Details
Published in:Dermatologic surgery 2011-03, Vol.37 (3), p.301-310
Main Authors: STEBBINS, WILLIAM G., HANKE, C. WILLIAM, PETERSEN, JEFFREY
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Cadaver
Dermatology
Dermis - transplantation
Female
Humans
Male
Medical sciences
Mohs Surgery
Patient Satisfaction
Postoperative Care
Reconstructive Surgical Procedures - methods
Scalp - surgery
Skin plastic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Transplantation, Homologous
Treatment Outcome
Wound Healing
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Summary:BACKGROUND Biologic scaffolds have shown promise in patients unable to tolerate prolonged surgical closure or extensive wound care, but there has been little research in the field of Mohs micrographic surgery (MMS) on human cadaveric dermis in this capacity. OBJECTIVE To evaluate the utility of human cadaveric dermis as a means of decreasing operative time, minimizing postoperative wound care, and improving aesthetic outcomes in selected patients with deep surgical defects, including those with exposed bone. METHODS Fourteen patients (8 men, 6 women) with deep postoperative defects after MMS were treated with a cadaveric dermal allograft as part or all of their postoperative wound management. RESULTS Allograft placement was well tolerated, with high satisfaction levels relating to minimal postoperative wound care and aesthetic outcome. Significantly shorter operative times were noted in all patients than with primary closure or grafting. CONCLUSION In patients with significant comorbidities, inability to tolerate extended surgical repairs, or inability to perform extensive wound care, human cadaveric dermal allografts can decrease operative time and minimize wound care complexity while providing an excellent aesthetic outcome in many cases. Shorter healing times than expected were also noted in a number of patients. The authors have indicated no significant interest with commercial supporters.
ISSN:1076-0512
1524-4725
DOI:10.1111/j.1524-4725.2011.01877.x