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Objective:To investigate the effect of artificial dermis combined with KCI negative pressure suction device in the repair of scalp defect with skull exposure after the operation of scalp malignancy.Methods:From January 2016 to June 2018, 18 patients with scalp defect and skull exposure after scalp malignant tumor surgery were treated with artificial dermis combined with KCI negative pressure suction device.Results:Eighten patients had good wound healing after the first stage of surgery, and no infection occurred. The time for artificial dermis to complete granulation was 10-14 days, with an average of 12.1 days. After the second stage of skin grafting, the skin graft had a survival rate of 100%, with uniform color and good elasticity, without obvious scar hyperplasia or contracture. The postoperative follow-up period was 6 to 2 months, all the patients healed well without tumor recurrence, with good skin elasticity and friction-resistant, and they were satisfied.Conclusions:Artificial dermis combined with KCI negative pressure suction device is an effective and simple method to repair the scalp defect with skull exposure after tumor surgery.
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Objective:To investigate the therapeutic effect of skull drilling and/or grinding combined with artificial dermis and vacuum sealing drainage in repairing scalp defects with skull exposure.Methods:From October 2014 to May 2018, 18 patients with scalp defect and skull exposure were treated in the Department of Burn and Plastic Surgery, the Second Clinical College of North Sichuan Medical College, including 10 males and 8 females, with an average age of 64 years (range, 34-86 years). The patients were divided into two groups: group A (by drilling skull or/and grinding combined with artificial dermis cover and vacuum sealing drainage plus two split thickness skin graft repair) and group B (by drilling skull or/andgrinding combined with artificial dermis cover plus two covering leather grinding stage split thickness skin graft repair), 9 cases in each group. The head wound granulation tissue, postoperative complications, skin graft survival rate and wound healing time were compared between the two groups. Vancouver scar assessment scale (VSS) was used to evaluate the wound healing in the two groups.Results:The time of granulation cultivation in group A and group B was (16.44±1.42) days and (29.11±13.32) days, the difference was statistically significant ( P<0.05); The wound healing time of group A and group B was (26.00±3.32) days and (40.67±14.37) days, the difference was statistically significant ( P<0.05); The postoperative complications of group A and group B were 1 case and 5 cases respectively, the difference was statistically significant ( P<0.05). The skin graft survival rates of group A and group B were (97.11±3.44)% and (95.00±4.74)%, the difference was not statistically significant ( P>0.05); The wound scar VSS scores of group A and group B were (7.67±1.32) points and (8.78±1.99) points, the difference was not statistically significant ( P>0.05). Conclusions:By drilling skull and/or grinding combined with artificial dermis cover and vacuum sealing drainage and two stage split thickness skin graft for repairing scalp defect with skull exposure wound can not only better scalp defect with skull exposure wounds, and reduce the postoperative complications, and significantly accelerate wound healing, but also can effectively improve the quality of wound healing, which is worthy of clinical application.
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Resumen Objetivo: Presentar 4 casos clínicos en los cuales el uso de dermis artificial Integra® resultó ser una solución segura y confiable para defectos de cuero cabelludo. Materiales y Método: Revisión de fichas clínicas de pacientes ingresados al Departamento de Cirugía Plástica y Quemados del Hospital del Trabajador de Santiago con diagnóstico de lesión traumática extensa de cuero cabelludo entre los años 2005-2013 que se resolvieron con uso de Integra®. Resultados: 4 pacientes de sexo femenino con lesión traumática que comprometían entre 70-98% de la superficie de cuero cabelludo, tiempo promedio entre aplicación de Integra® e injerto dermoepidérmico fue 18 días con 100% de cobertura; solo hubo complicaciones menores (ulceración crónica de vertex y dolor neuropático). El tiempo promedio de alta laboral fue 368 días, usando órtesis capilar. Discusión: La cobertura inmediata del tejido es fundamental para la reconstrucción exitosa del cuero cabelludo. Aparte del tejido autólogo, la dermis artificial constituye una alternativa para la reconstrucción rápida del cuero cabelludo con excelentes resultados. Conclusiones: Integra® es una solución segura y confiable para reconstruir defectos complejos del cuero cabelludo.
Aim: To present 4 clinical cases in which the use of artificial dermis (Integra®) turned out to be a safe and reliable solution for scalp defects. Materials and Method: review of clinical records of patients admitted to the Department of Plastic Surgery and Burns of the Hospital of the Worker of Santiago with a diagnosis of extensive traumatic injury of the scalp between the years 2005-2013 that were resolved with use of Integra®. Results: 4 female patients with traumatic injury that compromised between 70-95% of the surface of scalp, average time between application of integra and dermoepidermal graft was 18 days with 100% coverage; there were only minor complications (chronic vertex ulceration and neuropathic pain). The average time of high labor was 368 days, using capillary orthosis. Discussion: The immediate coverage of the tissue is essential for the successful reconstruction of the scalp. Apart from autologous tissue, the artificial dermis is an alternative for rapid reconstruction of the scalp with excellent results. Conclusions: Integra is a safe and reliable solution to reconstruct complex defects of the scalp.
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Humans , Female , Adult , Middle Aged , Scalp/surgery , Scalp/injuries , Skin Transplantation/methods , Skin, Artificial , Wounds and Injuries/surgery , Retrospective Studies , Treatment Outcome , Degloving Injuries/surgeryABSTRACT
Objective@#To explore the clinical effects of artificial dermis combined with vacuum sealing drainage (VSD) and autologous split-thickness skin graft in repair of scar contracture deformity after extensive burn.@*Methods@#A total of 8 patients with scar hyperplasia and contracture deformity on joint after healing of extensive burn were admitted to our hospital from August 2015 to August 2017. There were 5 females and 3 males aged 8 to 45 years with an average of 23 years. In the first stage operation, scar tissue on contracture site was removed, and the wound was covered by artificial dermis followed by continued VSD treatment. On 10-14 d after the first stage operation, the artificial dermis tissue formed, and the second stage autologous split-thickness skin grafting and continued VSD treatment were performed. Routine anti-scar therapy was carried out after healing of wounds. Time of wound healing after the second stage operation was recorded. Colour and texture of the split-thickness skin graft, scar formation condition of the donor site, and action condition of the operation site during follow-up were observed.@*Results@#The wounds of 8 patients were healed in 10-14 d after the second stage operation. During follow-up of 6-24 months, the split-thickness skin graft was with smooth surface and good elasticity, and the function of joint recovered well. The donor site in head healed well with no scar. Only pigmentation was left in the donor site of thigh, and scar was not obvious. The patients and their family members were satisfied.@*Conclusions@#After application of artificial dermis combined with VSD and autologous split-thickness skin graft in repair of scar contracture deformity after extensive burn, the skin grafting area and donor site were with unobvious scar hyperplasia, and the joint function in the operation area was good.
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Objective: To investigate the effect of Masquelet technique combined with artificial dermis on repairing bone and soft tissue defects in rabbits, and to observe the microstructure and vascularization of induced membrane, so as to guide the clinical treatment of Gustilo-Anderson type Ⅲ open fracture with large bone defect and soft tissue defect. Methods: Eighty male rabbits, weighing 2.03-2.27 kg (mean, 2.11 kg), were selected. The bilateral thighs of 64 rabbits were randomly divided into experimental group and control group, the remaining 16 rabbits were sham operation group. Bone and soft tissue defect models of femur were made in all rabbits. In the experimental group, the first stage of Masquelet technique was used [polymethyl methacrylate bone cement was filled in bone defect area] combined with artificial dermis treatment; in the control group, the first stage of Masquelet technique was used only; in the sham operation group, the wound was sutured directly without any treatment. Four rabbits in sham operation group and 16 rabbits in the experimental group and control group were sacrificed at 2, 4, 6, and 8 weeks after operation, respectively. The induced membranes and conjunctive membranes were observed on both sides of the femur. The membrane structure was observed by HE staining, and the microvessel density (MVD) was counted by CD34 immunohistochemical staining. Results: Gross observation showed that the spongy layer of collagen in the artificial dermis of the experimental group disappeared completely at 4 weeks after operation, and the induced membrane structure of the experimental group and the control group was complete; the membrane structure of the control group was translucent, and the membrane structure of the experimental group was thicker, light red opaque, accompanied by small vessel proliferation. The membrane structure of the experimental group and the control group increased gradually from 6 to 8 weeks after operation. In the sham operation group, only scar tissue proliferation was observed over time. HE staining showed that a large number of muscle fibers and a small amount of collagen fibers proliferation with inflammatory cell infiltration could be seen in the experimental group and the control group at 2 weeks after operation; most of the sham operation group were muscle fibers with a small amount of interfibrous vessels. At 4 weeks after operation, collagen fibers increased and some blood vessels formed in the experimental group. The nuclei of collagen fibers in the control group were round-like, while those in the experimental group were flat-round. At 6 and 8 weeks after operation, the collagen fibers in the experimental group and the control group increased. The nuclei of the collagen fibers in the control group were still round-like. The nuclei of the collagen fibers in the experimental group were fusiformis and deeply stained compared with those in the control group. The proliferation of blood vessels was observed in both groups, and the number of proliferation vessels in the experimental group was increased compared with that in the control group. In the sham operation group, a large number of fibroblasts still appeared, but no significant proliferation of blood vessels with time was observed. CD34 immunohistochemical staining showed that MVD in each group increased gradually with the prolongation of time after operation. MVD in the sham operation group was significantly higher than that in the experimental group and the control group at 2 weeks after operation, and significantly smaller than that in the experimental group and the control group at 4, 6, and 8 weeks after operation ( P0.05). Conclusion: Masquelet technique combined with artificial dermis in the treatment of femoral bone defect and soft tissue defect in rabbits can significantly promote the vascularization of membrane structure at 4-6 weeks after operation. The combination of these two methods has guiding significance for the treatment of Gustilo-Anderson type Ⅲ open fracture with bone and soft tissue defects.
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Objective To compare 2 kinds of artificial dermis Lando(R) versus Pelnac(R) combined with induced membrane technique in the treatment of composite trauma in rabbit bilateral femurs.Methods Twenty-seven male rabbits,weighing from 1.92 kg to 2.21 kg (average,2.04 kg),were used in the experiments.After models of composite trauma were created in the bilateral femurs of all the rabbits,the bilateral femurs of 9 random rabbits were subjected to the treatment of artificial dermis Lando(R) plus induced membrane (Lando(R) group),the bilateral femurs of another 9 random rabbits to the treatment of artificial dermis Pelnac(R) plus induced membrane (Pelnac(R) group),the left femur of the remaining 9 rabbits to the treatment of induced membrane (control group) and the right femur of the remaining 9 rabbits to no treatment (sham operation group).Three rabbits from each group (the same for the control and sham operation groups) were randomly sacrificed at 2,4 and 6 weeks after operation.Samples from the operation sites were taken for gross observation of the induced membrane and observation of the microstructure of the membrane by conventional hematoxylin-eosin staining.In addition,the microvessel density (MVD) was counted under microscopy taking CD34 immunohistochemistry as the standard.The data were statistically analyzed.Results The collagen sponge layer was completely degraded 2 weeks after operation in the Lando(R) group but not in the Pelnac(R) group.The MVD [(0.90 ± 0.55)/HPF] in the Lando(R) group was significantly greater than that in the Pelnac(R) group [(0.28 ± 0.13)/HPF] (P ＜ 0.05).The collagen sponge layer was degraded 4 weeks after operation in the Lando(R) and Pelnac(R) groups and there was no significant difference between the 2 groups in MVD [(3.61 ± 1.31)/HPF versus (4.34 ± 0.77)/HPF] (P ＞ 0.05).At 6 weeks postoperatively,the MVD [(4.97 ±0.76)/HPF] in the Lando(R) group was significantly smaller than that in the Pelnac(R) group [(7.06 ± 1.03)/HPF] (P ＜ 0.05).At 2 weeks after operation,the MVD was (0.11 ±0.19)/HPF in the control group and the sham operation group,showing a significant difference compared with the Lando(R) group (P ＜ 0.05) but no significant difference compared with the Pelnac(R) group (P ＞ 0.05).The MVD at 4 and 6 weeks after operation in the control and the sham operation groups were all significantly different from those in the Lando(R) and the Pelnac(R) groups (P ＜ 0.05).Conclusions In the treatment of composite trauma in rabbits,the 2 kinds of artificial dermis combined with the induction membrane technique can lead to formation of induced membrane structure,providing a new alternative treatment for patients with bone and soft tissue defects caused by various causes in the clinic.The Lando(R) artificial dermis may accelerate the vascularization of induced membrane at 2 weeks while the Pelnac(R) may accelerate the vaseularization at 4 and 6 weeks.
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Objective@#To explore the clinical effect of artificial dermis on partial nail bed defects.@*Methods@#From May 2013 to September 2016, 16 cases of 21 fingers with partial nail bed defect and bone exposure received primary repair with artificial dermis after debridement. Then the outer dressing was changed 3 days after the operation, and the dressing was changed once every 3 to 5 days. The pink dermis like tissue was placed on the wound surface 2 to 3 weeks after the operation. The wound surface was naturally epithelialized.@*Results@#All the fingers were survived after artificial dermis repair, and the fingertip surface of nail bed defect was epithelialized naturally and healed well. Postoperative follow-up was 5 to 16 months, with an average of 8.2 months. The growth of fingernails was smooth with symmetrical appearance, natural toughness, good adhesion between the nail body and the nail bed, and no pain or hyperesthesia at the tip. Results of curative effect evaluation showed excellent in 18 fingers, good in 3 fingers. Results of patient′s satisfaction with postoperative finger appearance showed very satisfactory in 13 cases and satisfactory in 3 cases.@*Conclusions@#The method of repairing partial defect of nail bed using artificial dermis is simple with minimal damage and a good clinical effect.
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BACKGROUND: When a skin defect occurs, clinicians must work to restore the original skin quality as soon as possible. Accordingly, an artificial dermis can be used to supplement the wound and prevent severe scar contracture formation. The Terudermis is an artificial dermis that is simple and easy to use. We investigated the effectiveness of the Terudermis in the treatment of facial skin defects by analyzing previous relevant cases treated in our institution. METHODS: We retrospectively examined 143 patients who were treated with the Terudermis graft in facial skin defect at Dong Kang General Hospital in 2015 and 2016. The patients’ age, sex and location, wound size, complications were analyzed. In addition, the patients were asked to complete a self-satisfaction questionnaire after 18 months from the completion of treatment. The results were compared with that of autologous full-thickness skin graft (FTSG) and split-thickness skin graft (STSG) patients in same period. RESULTS: The mean self-satisfaction scores evaluated by patients were 4.1±1.0, 4.0±1.3 and 3.5±1.8 for the Terudermis graft, FTSG and STSG patients, respectively. With respect to complications, there were fewer incidences of hematoma, partial skin loss and complete skin loss in the Terudermis graft patients. CONCLUSION: In the present study, the Terudermis, when used to treat post-traumatic facial skin defects, is a good alternative option to obtain satisfactory aesthetic outcomes. Also, the Terudermis grafting is a simple and easy treatment method to perform.
Subject(s)
Humans , Cicatrix , Contracture , Dermis , Hematoma , Hospitals, General , Incidence , Methods , Retrospective Studies , Skin , Transplants , Wounds and InjuriesABSTRACT
Objective To observe the clinical effects of dermis combined autologous transplants in patients with abnormal scar thickness skin graft.Methods 13 cases of scar deformity were selected during August 2011 to December 2014 in our hospital.In stage 1 procedure,the scars that affected the function and induced deformities were resected and then the artificial dermis covering the wound was placed;in stage 2,two weeks after the artificial dermis vascularization,autologous skin grafts were removed to repair the wound edge.Meanwhile,therapy of inhibiting scar after conventional treatment was conducted with funcitional exercise.Results 13 cases were scheduled to repair scar wounds,underwent surgery with more than 6 months follow-up observation.The dysfunctions caused by scar contracture and deformity were significantly improved;appearance,elasticity and appearance of the skin grafts were similar to autologous skin graft with the desired clinical effect.Conclusions Artificial dermis combined autologous skin graft treatment of patients with scar deformity can achieve similar clinical effects to traditional treatment methods.
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PURPOSE: Aim of this study was to assess effects of InsureGraf® (SK-Bioland Co., Korea), an artificial dermis developed by using tissue engineering technology in severe burn patients. METHODS: To examine the clinical effectiveness of InsureGraf®, we transplanted them in patients with severe burns. A total of 14 joint regions in 8 patients received InsureGraf® graft selectively from July to December, 2014. The graft results were determined after confirming the take rate of the transplanted skin graft on top of the InsureGraf®. Take rates were examined twice, at 7 and 14 days after grafting. Photographs of the skin grafts were evaluated individually by two burn surgeon specialists, and the mean values were recorded. RESULTS: The take rate was 99% after day 7 and 100% after day 14 respectively. CONCLUSION: InsureGraf® can be used successfully as an artificial dermis that allows one-stage operation in severe burn patients, exhibiting a successful early-stage graft take rate that is close to 100%.
Subject(s)
Humans , Burns , Collagen , Dermis , Joints , Skin , Specialization , Tissue Engineering , Transplants , Treatment OutcomeABSTRACT
Objective To investigate the clinical efficacy of artificial dermis scaffold combined with autologous split-thickness skin graft in repairing deep wounds on hands and feet after extensive burn by comparing with the traditional ways. Methods The patients with deep wounds on hands and feet, who were treated in Department of Burn Surgery, Changhai Hospital, Second Military Medical University from March 2012 to March 2015, were selected as participants. A total of 28 patients meeting the inclusion criteria were allocated into two groups according to the operations. The observation group (14 cases) received artificial dermis scaffold after crust resectional therapy at 4-7 days after burns, and they also received autologous split-thickness skin graft following crust resectional therapy at 21-28 days after burns. The control group (14 cases) received changing medicine to maintain the scab following crust resectional therapy at 4-7 days after burns, and they also received autologous split-thickness skin graft following crust resectional therapy at 28-35 days after burns. The following data were recorded: the operation time, survival rate of skin graft, the cause of the flap necrosis, healing time of donor site and whether it could donor more flap or not, and the hyperplastic scars on hands and feet. Results The observation group needed similar operation time when compared with the control group for the first operation ([4.50±0.76] h vs[4.14±0.86] h,P>0.05), while the second operation time of the observation group was significantly shorter than that of the control group ([2.11±0.35] h vs [3.39±0.49] h, P<0.001). When changing the medicine at the 8th day after skin grafting, the survival rate of skin graft in the observation group was 97.37%(37/38) and the infection rate was 2.63%(1/38); the survival rate of the whole skin graft in control group was 73.68%(28/38), and that of partial skin graft was 23.68%(9/38), with an infection rate of 2.63%(1/38). The healing time of donor site in the observation group was significantly shorter than that of the control group([6.07±0.83] d vs [14.64±0.93] d, P<0.001). And it was estimated that 78.57%(11/14) of the patients in the observation group and 14.29%(2/14) of patients in the control group could donor more graft(P<0.05). One year follow-up showed that hyperplastic scars on hands and feet in the observation group was significantly better than those in the control group according to the Vancouver Scar Scale (VSS, [5.07±1.21] vs [8.07±1.14], P<0.001). Conclusion Artificial dermis scaffold can be used at early time in repairing deep wounds on hands and feet after extensive burn, with no need for additional operation time; and both the survival rate of skin graft and long-term function are good, with less damage to the donor site.
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<p><b>OBJECTIVE</b>To investigate the effect of vacuum sealing drainage (VSD) combined with artificial dermis for treatment of the ankle and foot soft tissue defects.</p><p><b>METHODS</b>A total of 15 patients with skin and soft tissue defect of ankle and foot were treated from January 2011 to December 2013, including 10 males and 5 females, with an average age of 32.5 years old ranging from 3 to 55 years old, involving 8 cases by traffic accident, 2 cases by machine accident, 5 cases by crush injury;8 cases with soft tissue exposure, 2 cases with tendor exposure, 5 cases with bone exposure. VSD was used to cover the wounds and continuous negative pressure drainage after debridement, the wounds covered with artificial dermis after the second granulation tissue grew well, again VSD was used to cover the wounds and negative pressure suction was applied, after 7 to 14 days negative pressure closed drainage was removed, free skin graft was transplanted above the artificial dermis, sterile gauze was used to compression bandage.</p><p><b>RESULTS</b>All cases were followed up for 3 to 14 months with an average of 6.5 months. Skin graft of 15 of patients survived after transplantation, artificial dermis graft interval was 7 to 14 days with an average of 9.5 days. There was no obvious scar hyperplasia and contracture, no obvious pigmentation, appearance and functional recovery.</p><p><b>CONCLUSIONS</b>After the implantation of artificial dermis and traditional skin graft method need for 2 to 3 weeks, vacuum sealing drainage technique combined with artificial dermis in treatment of soft tissue defect of foot and ankle skin has advantages of simple operation, significantly shorten the time of the second phase of the skin, without flap to repair, little injury to donor skin area, wound healing quality high, clinical effect of satisfaction.</p>
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Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery.
Subject(s)
Humans , Dermis , Forehead , Free Tissue Flaps , Hemangiosarcoma , Methods , Scalp , Skin , Skull , TransplantsABSTRACT
[ Abstract]Objective To investigate the effect of two-tage skin grafting with artificial dermis for perianal hidradenitis suppurativa. Methods A total of 20 cases diagnosed as perianal hidradenitis suppu-rativa in our hospital were selected from 2011 to 2013. In the first-stage operation,all diseased skin inclu-ding the superficial subcutaneous fatty tissue was excised,and normal deep subcutaneous fatty tissue was preserved. Then,artificial dermis was grafted to the preserved fatty tissue. After two weeks,split-hickness skin grafts were used for the skin defects as the second-tage operation. Graft success,recurrence and post-operative appearance were evaluated in these patients who were followed up for 9 to 28 months. Results Skin grafts of all 19 patients were successfully survived. The recurrence of hidradenitis suppurativa oc-curred in only one patient. This patient was treated with reoperation and the postoperative appearance was welly recovered. Conclusion Two-tage skin grafting with artificial dermis appears to be a good treatment option for perianal hidradenitis suppurativa.
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Objective To summarize key points of nursing the patients with hot-press injury in hands treated with artificial dermis.Method The nursing measures by summary included preoperative psychological counseling,raising the affected limbs in case of edema,keeping wounds clean,keeping the affected limbs immobilized,instructing them in functional exercise.Results All 10 cases were cured.Excellent results were obtained in hand function and shape.Conclusions Preoperative mental care can improve the patients’confidence and make them cooperative positively in treatment and postoperative rehabilitative exercises. Postoperative close observation of the disease conditions and good care to the wounds together with right instruction in hand function exercises are critical for the recovery of hand function.
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PURPOSE: CryoDerm (CGbio) is derived donated human skin. After removing epidermis and fibroblast of dermal layer, it preserved with cryo-preservation technique using control rate freezer system. To prevent post burn joint contracture in massive burns, we have used CryoDerm in acute stage. METHODS: From January of 2010 to July of 2012, 50 patients who undergone CryoDerm graft with split thickness skin graft were reviewed. The operative method was as follows: 1) Early wound excision and or cadaveric allograft skin coverage was performed within 5 days after burn injury 2) 2~3 weeks after wound excision, split thickness skin graft was performed with CryoDerm graft. Then graft take rate was investigated by inspection. Follow up duration was 3~32 months. RESULTS: Mean age of patients was 42.2 (2~70) years. Mean percentage of total body surface area burned was 27.22% (1~61%). Among 50 patients, 98 joints was operated including 14 hands, 4 wrists, 10 shoulders, 23 elbows, 4 necks, 3 hip joints, 31 knee joints and 9 ankles and feet. Total used graft size of Cryoderm was 10,945 cm2. Average take rate was near 100%. CONCLUSION: Cryoderm graft with split thickness skin graft can be used as a safe and effective operative method for one stage operation in acutely burned patients.
Subject(s)
Animals , Humans , Ankle , Body Surface Area , Burns , Cadaver , Contracture , Elbow , Epidermis , Fibroblasts , Follow-Up Studies , Foot , Hand , Hip Joint , Joints , Knee Joint , Neck , Shoulder , Skin , Transplantation, Homologous , Transplants , WristABSTRACT
Verrucous carcinoma is a distinctive form of low-grade squamous cell carcinoma. The tumor has an exophytic, cauliflower-like appearance, and usually occurs in males and tends to affect individuals over 60 years of age. It typically involves the oral cavity, larynx, esophagus and skin. Most intraoral cases involve the mandibular vestibule, the buccal mucosa and the hard palate. The cause is unknown, but most verrucous carcinomas arise from the oral mucosa in people who chronically use chewing tobacco or snuff. The treatment of oral verrucous carcinoma remains controversial. Whenever possible, surgically total excision and skin or mucosal grafting is recommended. After total excision of huge verrucous carcinoma,instead of dermal or mucosal grafting, we used artificial dermis silicone membrane. We had a good result without recurrence and present this case.
Subject(s)
Humans , Male , Carcinoma, Squamous Cell , Carcinoma, Verrucous , Dermis , Esophagus , Larynx , Membranes , Mouth , Mouth Mucosa , Palate, Hard , Recurrence , Silicones , Skin , Tobacco, Smokeless , TransplantsABSTRACT
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Humans , Forearm , Hand , Hand Strength , Neck , Skin , Tendons , Tissue Donors , Transplants , WristABSTRACT
PURPOSE: Numerous materials, both autologous and nonautologous, have been used for augmentation of sunken areas, but they have their own limitations. The purpose of this study is to determine the histologic response and volume change of the xenogenic collagen-based scaffold(Terudermis(R)) to the transfer into a subcutaneous soft tissue location in vivo rabbit model. METHODS: Eighteen New Zealand white rabbits were used. Three 1.2x1.2cm sized subcutaneous pockets were created on the dorsal surface of each ear. 1x1 cm sized collagen matrix(Terudermis(R)) and autologous dermal graft were implanted into each pocket. Full thickness of ear was harvested in 3 days, 1, 2, 4 weeks, 3, 6 months after implantation. RESULTS: Histological analysis of implants demonstrated progressive neovascularization, fibroblast infilteration, neocollagen bundle synthesis and organization, and few foreign body reaction. The thickness of the collagen matrix in 3 days after the operation was 87.69% of the thickness of the collagen matrix in wet state. Then it decreased to 30.17% in 6 months after the operation. The rate of decrease was similar at all points at the same time compared with autologous dermal graft. CONCLUSION: Our experimental study suggests that Terudermis(R) could be a safe material as an implant for permanent augmentation in subcutaneous tissue. However the choice of graft for augmentation should be remained to the clinical situations.
Subject(s)
Rabbits , Collagen , Ear , Fibroblasts , Foreign-Body Reaction , Subcutaneous Tissue , TransplantsABSTRACT
The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis(R).) after the transplantation, and to report the clinical results of the use of Terudermis(R). in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis(R). size 1 x 1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis(R). graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis(R). In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis(R). graft. In clinical data of 17 patients, the size of the grafted Terudermis(R). was from 1.5 cm2 to 7.5 cm2 (average 3.5 cm2). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis(R). can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.