Integra in lower extremity reconstruction after burn injury.
BACKGROUND
Standard care for lower extremity injuries with exposed bone or tendon is vascularized tissue transfer. In patients with deep and extensive burn injuries, these options are often not available or for various reasons are technically difficult. The advent of Integra, a permanent dermal replacement matrix, provides an important alternative to the traditional reconstructive choices.


METHODS
The authors report seven patients, with a total of nine lower extremity injuries, from the Los Angeles County and University of Southern California Hospital Burn Unit treated from September of 2001 to January of 2003 who presented with complex burn injuries involving their lower extremities with tendon, open joints, and/or bone exposure.


RESULTS
All seven patients were treated initially with tangential excision of the burn eschar and placement of Integra. After engraftment, epidermal coverage was restored with a thin split-thickness skin graft. This treatment provided stable wound coverage, and none of the patients have required further surgical procedures to maintain wound closure.


CONCLUSIONS
The use of a bioengineered, cell-free dermal matrix expands reconstructive options and allows salvage of extremities that might otherwise have been amputated or required prolonged, staged procedures. The authors' experience shows that Integra provides a sound alternative option for providing durable coverage of vital lower extremity structures. It should be considered as part of the lower extremity wound coverage algorithm.
Lee
Lily F
LF
Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of Southern California, Keck School of Medicine, Los Angeles County and University of Southern California Medical Center.
Porch
Juliet V
JV
Spenler
William
W
Garner
Warren L
WL
D000328:Adult; D002056:Burns / Q000601:surgery*; D002648:Child; D002809:Chondroitin Sulfates; D003094:Collagen; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin / Q000293:injuries*; D017768:Skin, Artificial
C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen