title: Dermal equivalents in oncology: benefit of one-stage procedure.
abstract: BACKGROUND
  In oncology, dermal equivalent may be indicated to cover losses of substance related to skin tumors or after the removal of skin flaps.
  
  
  OBJECTIVE
  To report our experience of two dermal equivalents, Matriderm 1 mm with a one-stage graft (DE1) and Integra DL with a two-stage graft (DE2) in oncology.
  
  
  METHODS
  Retrospective, single-center study involving 16 patients.
  
  
  RESULTS
  Sixteen patients received dermal equivalents as an alternative to flaps (7 cases), over tendinous areas (7 cases), and for cosmetic purposes (2 cases). Twelve patients received DE1 and four DE2. Wound healing times with DE1 were 4 weeks less than those with DE2. Three cases of infection were noted with DE2. The use of dermal equivalents as an alternative to skin flaps was effective, and no adhesions were found over the tendinous areas.
  
  
  CONCLUSIONS
  The learning curve, the two-stage graft required with DE2, and not using a vacuum-assisted closure system can explain the high infection rate. The use of dermal equivalents is particularly indicated in the treatment of skin defect in oncology. The possibility of a one-stage graft with DE1 and combination with negative pressure therapy is beneficial.
authors.affiliation: Orthopedic, Traumatology, Plastic Reconstructive, and Hand Surgery Unit, University Hospital of Besançon, Besançon, France. jpauchot@chu-besancon.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Pauchot
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elkhyat
authors.forename: Gwenael
authors.initials: G
authors.lastname: Rolin
authors.forename: Sophie
authors.initials: S
authors.lastname: Mac
authors.forename: Anne
authors.initials: A
authors.lastname: Grumblat
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fotso
authors.forename: Philippe
authors.initials: P
authors.lastname: Humbert
authors.forename: Yves
authors.initials: Y
authors.lastname: Tropet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002809:Chondroitin Sulfates / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D004549:Elastin / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010039:Otorhinolaryngologic Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D017768:Skin, Artificial; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult
chemical_list: C114835:integra artificial skin; C532298:matriderm; D002809:Chondroitin Sulfates; D003094:Collagen; D004549:Elastin