[Use of Integra in a case of extensive upper extremity avulsion]. / Kiterjedt felso végtagi nyúzásos sérülés kezelése Integra mesterséges borrel.

Authors performed successful skin replacement with Integra, a dermal regeneration template, on a patient with circumferential avulsion injury including the elbow region and the dorsum of the hand. The take rate of Integra was 97%, followed by a 98% take rate of the split thickness mesh graft used for final wound coverage. Treatment modality provided excellent aesthetic and functional results, underlining the role of Integra in cases of extensive traumatic skin and soft tissue deficit, such as the treatment of avulsion injury.

[Posterior circumflex humeral artery perforator flap (PCHAP-flap) in axillary scar release]. / Arteria circumflexa humeri posterior perforátor (PCHAP) lebeny alkalmazása axillaris hegkorrekcióban égési sérülés után.

Scar contracture after burn injury is frequent in the axillary region. If conservative treatment of scars limiting the range of motion of the shoulder joint fails, surgical correction is needed. The authors performed an early reconstruction in a case with unstable scar formation and limited range of motion after burn injury to the axillary region, using the posterior circumflex humeral artery perforator flap. In their opinion, the flap (beside its conventional use as a free flap) may be useful as an island flap in the reconstruction of the axillary region, e. g. for axillary scar release.

[The use of Integra "artificial skin, dermal regeneration template" and the reverse radial forearm fasciocutaneous flap in the primary reconstruction of a septic hand injury]. / Integra "mesterséges bor, irha-újraképzodési minta" és reverz radiális lebeny alkalmazása szeptikus kézsérülés elsodleges rekonstrukciójában.

Reconstruction was performed on the back of a hand following a poorly managed septic hand injury leading to skin and extensor apparatus necrosis using a reverse radial forearm fasciocutaneous flap and a bilayer artificial skin substitute. CASE DEMONSTRATION: Authors report on the first Hungarian case using Integra dermal regeneration template. Integra was placed on the back of the hand on an area left uncovered by the reverse radial forearm fasciocutaneous flap as well as on the flap harvest area. After biointegration of the regeneration template, the outer silicon layer was removed and a split thickness skin graft was applied. CONCLUSION: The take-rate on the donor area was 100% for Integra and 99% for the skin graft, and 90% for both Integra and the skin graft on the back of the hand, providing a good functional and aesthetic result.

[Skin replacement with biological and biosynthetic materials following burn injury]. / Bôrpótlási lehetôségek biológiai és bioszintetikus anyagokkal kiterjedt égési sérülésben.

Autotransplantation is currently regarded as the optimal skin replacement method, sufficient donor site, however, is often not available in extensively burned patients. Intensive research and development of skin replacement products is conducted worldwide in order to decrease the size of the required donor site. Short- and long-term wound coverage is made possible by temporary synthetic and non-synthetic skin substitutes. Autografts and cultured epithelial autografts are used for permanent skin substitution. Until this is possible, the barrier function of the skin is provided by bio-engineered temporary skin substitutes. Some products and methods are currently available in Hungary, while others are still in the introductory phase. In order to provide an overview, authors summarize the skin replacement methods and compare the different skin replacement products used worldwide from the perspective of the burn surgeon. The use of new methods to be introduced in the near future needs to be rationalized due to financial considerations.