(CS-114) Double Reconstructive Surgery for Cutaneous Tumor using Dermal Regeneration Template in a Patient who Required Radiotherapy

Skin defect reconstruction following cancer resection occasionally poses a significant challenge for the surgeon. Dermal Regeneration Template (DRT, Integra LifeSciences) is a bilayer xenogenic acellular dermal matrix that has been widely used for the management of burn injuries, acute and chronic wounds, and for plastic surgery. However, little is reported on its use in oncologic dermatological defects, particularly for patients who require radiotherapy by oncology indication.

Methods:

We report the case of 1 patient who showed recurrence 6 months after DRT placement, requiring a new second two-stage DRT-autograft procedure before radiation therapy. Patient was followed for a period of 12 months, after the second DRT-autograft procedure. The patient gave consent for use of his data. The patient was a 77-year old male who has a squamous cell carcinoma in the calvaria. The patient had hypertension and diabetes. The defect size was 25 cm² after debridement.

Results:

The patient underwent a first DRT-autograft procedure. This patient showed recurrence after the first two-stage procedure. The pathological finding resulted in perineural invasion in the context of an immunosuppressed patient after liver transplant. This patient required radiotherapy by oncology indication. A new second two-stage DRT-autograft procedure was performed for wound closure. Radiotherapy (60 Gys) was applied over the calvaria and conducted 1 month afterwards. There was no recurrence after 1-year monitoring for this patient and no radiodermatitis was found. The patient was not completely satisfied with cosmetics after the second two-step procedure, although approved contour and texture.

Discussion:

DRT and its variants are the most-widely used acellular dermal matrices. Our results showed that DRT is a valid option for reconstructive surgery for patients with oncologic dermatological defects, who will eventually need adjuvant radiotherapy.

Trademarked Items: Integra Dermal Regeneration Template
Integra Bilayer Wound Matrix

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