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

• 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
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2011.01877.x

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.