title: Use of Integra in complex pediatric wounds.
abstract: The usefulness of Integra is well described in the adult reconstructive and burn literature. There is limited documentation of its utility in the pediatric plastic surgery population. We presented 8 cases referred to us for flap coverage that were treated using Integra. These cases describe difficult wounds resulting from trauma, and congenital abnormalities. The charts of all 8 cases were retrospectively reviewed. There were 5 females and 3 newborns. The average age at coverage with Integra was 4.6 years (range, 1 day-16 years). There were 4 traumatic wounds, 2 cases of cutis aplasia, 1 myelomeningocele, and 1 case of congenitally absent cranium. The average time to coverage was 8 days, and all trauma patients underwent at least 2 prior washout procedures. The average area covered was 43 cm (range, 6-100 cm). At a mean follow-up of 14.25 months (range, 9-20 months), 7 patients' wounds had healed without need for further flap coverage. Only 1 patient required a skin graft over the Integra bed. There was 1 infection resulting in total dermal matrix loss and need for local flap reconstruction. One patient developed severe hypertrophic scarring requiring surgical revision. Integra is a reliable option in pediatric reconstruction, which may save a child the morbidity of a more extensive procedure.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Emory University, Atlanta, GA, USA. bahair@gmail.com
authors.forename: Bahair H
authors.initials: BH
authors.lastname: Ghazi
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D015331:Cohort Studies; D003094:Collagen / Q000627:therapeutic use*; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000601:surgery
chemical_list: C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen