[Reconstructive surgery using an artificial dermis (Integra): results with 19 grafts].
BACKGROUND
Integra was initially developed for covering of acute burn wounds. The artificial dermis is a bilayered dermal substitute, the upper layer is a thin silicone layer, which acts as temporary epidermis, the under layer is a collagen network, which functions as the dermis. In the meantime, Integra is applicated in reconstructive surgery.


METHODS
We present a series of 12 patients who underwent reconstructive surgery with Integra grafting for a total of 19 operational sites. The average area grafted per procedure was 210 cm(2) (15-1 200 cm(2)). The operation sites were located at the extremities, trunk and head-neck. The split thickness skin graft was performed, on average, after 20 days (16-29 days). The patients were admitted for 41 days on average (24 days-3 months). The follow-up was after 17 months (9-30 months).


RESULTS
Early complications included seroma, loss of Intregra, and infection. Late complications were instable scars. In five cases, we found slight hypertrophe scars in borderline between healthy skin and covering with Integra.


CONCLUSIONS
The advantages of using Integra in reconstructive surgery are its immediate availability and the availability in large quantities. Disadvantages are the necessity of two operations, risks of infection, the high price and time-consuming dressing changes. Defect covering with Integra should be used in special cases.
Unglaub
F
F
Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Universitätsklinikum Aachen. funglaub@ukaachen.de
Ulrich
D
D
Pallua
N
N
D000328:Adult; D000368:Aged; D002056:Burns / Q000601:surgery*; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*