Artificial skin as a valuable adjunct to surgical treatment of a large squamous cell carcinoma in a patient with epidermolysis bullosa.
BACKGROUND
Among tissue-engineered skins, two bilayered cellular constructs and one cryopreserved dermal substitute have been approved for the treatment of epidermolysis bullosa. Nevertheless, the application of artificial skin technology to surgical treatment of squamous cell carcinomas in a patient with epidermolysis bullosa has never been reported.


OBJECTIVE
To reconstruct the large defect remaining after squamous cell carcinoma excision in a patient with dominantly inherited dystrophic epidermolysis bullosa.


METHODS
To apply a 10 x 15 cm Integra sheet (Integral Life-sciences Corporation, Plainsboro, NJ, USA) (an acellular collagen matrix coated with a thin polysiloxane elastomer) to the excised area and 3 weeks later to cover the Integra sheet with an ultrathin meshed skin graft.


RESULTS
The graft take was complete, and the donor site totally regenerated, except for three small bullae at 7 weeks postoperatively.


CONCLUSIONS
Integra offers the advantage of filling huge defects with its dermal layer of collagen fibers and provides an optimal graft bed. This first step makes it possible to use very thin grafts 3 weeks later.
Dagregorio
Guy
G
Federation of Dermatology and Plastic Surgery, Centre Hospitalo-Universitaire de Poitiers, Poitiers, France. verone4@wanadoo.fr
Guillet
Gerard
G
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery*; D002809:Chondroitin Sulfates; D003094:Collagen; D015897:Comorbidity; D004820:Epidermolysis Bullosa / Q000453:epidemiology*; D006801:Humans; D012878:Skin Neoplasms / Q000453:epidemiology / Q000601:surgery*; D017768:Skin, Artificial
D001672:Biocompatible Materials; C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen