Johnson MB, Wong AK, et al.
Plastic and reconstructive surgery. Global open. Date of publication 2016 Oct 24;volume 4(10):e1074.
1. Plast Reconstr Surg Glob Open. 2016 Oct 24;4(10):e1074. eCollection 2016 Oct.
Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic
Review of the Literature.
Johnson MB(1), Wong AK(1).
Author information:
(1)Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck
School of Medicine of the University of Southern California, Los Angeles, Calif.
BACKGROUND: Large complex scalp wounds that have traditionally required free
vascularized tissue transfer have been successfully reconstructed with skin
substitutes such as Integra. Although there are multiple reports of Integra-based
reconstructions of scalp wounds, there has not been a comprehensive assessment of
this body of literature that critically examines this method. Our goal was to
conduct a systematic review to determine the effectiveness of Integra-based
reconstructions of scalp wounds, with emphasis on large defects.
METHODS: A comprehensive systematic review was completed using key search terms,
including Integra, dermal regeneration template, bovine collagen, skin
substitute, forehead, and scalp. Selected articles reported characteristics of
patients and their reconstructions. The primary outcome measures were wound
complications and percent graft take.
RESULTS: Thirty-four articles were included in this systematic review. Wound
sizes ranged from 5.7 to 610 cm2, with 35.3% of articles reporting a mean defect
size >100 cm2. Thirty-two articles reported mean percent take of skin graft ≥90%.
Sixteen articles reported a minor complication. There were no major complications
associated with the reconstructions.
CONCLUSIONS: There is a substantial evidence base for the use of Integra to
reconstruct scalp wounds. To date, the dermal regeneration template is generally
reserved for salvage procedures or when the patient cannot tolerate free tissue
transfer. Based on the findings of this systematic review and the authors'
clinical experience, Integra can be used to achieve predictable results in large
complex scalp defects.
DOI: 10.1097/GOX.0000000000001074
PMCID: PMC5096526
PMID: 27826471
