The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Teodora Hoinoiu,Georgeana Prilipceanu,Daciana Grujic,Ljubisa Grujic,Tiberiu Bratu,Bogdan Hoinoiu,Roxana Folescu,Vladimir Poroch

doi:10.3390/app10113731

Abstract

Glycosaminoglycan (GAG) is a chain-like disaccharide that is linked to a polypeptide core to connect two collagen fibrils/fibers and provide the intermolecular force in a Collagen-GAG matrix which can be a valuable treatment of post-burn contractures and hypertrophic scars, which remain a challenge to reconstructive surgery. The face and neck contractures are the most difficult sites to treat. This article is meant to discuss our clinical experience in using collagen-glycosaminoglycan biodegradable matrix (Integra® Integra Lifesciences Corporation, Plainsboro, NJ, USA) to reconstruct defects created by excision of contracted areas from the neck and lower face areas. Between 2009 and 2011, we had 11 patients that underwent Integra reconstructive procedures. The mean follow-up period was 18 months. For all the patients, the intake of the Integra dermal regeneration template was 100%, even if one patient developed a minor infection treated with appropriate antibiotics. The patients are very satisfied with the result. A minor problem was a small difference in skin color, but this inconvenience was compensated by good skin elasticity.

Highlights

Hypertrophic scars and keloids still represent a difficult management problem for plastic surgeons.Burns of the face and neck are a challenge for plastic surgeons because the lack of adequate coverage in this region can lead hypertrophic scars and keloids causing important functional limitations and subsequent disability
[19] Literature reports the use of the dermal matrix for reconstruction of defects created by skin graft removal, excision of benign or cancer tumors and for covering of soft tissue following trauma. [20,21,22,23] Despite all the reports of burn wounds recovered do to the use of different artificial dermal templates, we find it relevant to share our experience in neck burn scars regarding reconstructive surgery with the applications of the Integra dermal regeneration template
2009 and November 2012, 11 patients ranging in age from 21 to 50 years with hypertrophic scars and retractions on the neck underwent reconstructive procedures with the Integra dermal regeneration template

Summary

Introduction

Hypertrophic scars and keloids still represent a difficult management problem for plastic surgeons. Burns of the face and neck are a challenge for plastic surgeons because the lack of adequate coverage in this region can lead hypertrophic scars and keloids causing important functional limitations and subsequent disability. Scarring and tissue loss from second- and especially third-degree burns spontaneously healed or covered with skin grafts can usually cause deformities, and more rare are posttraumatic sequelae, or after the surgical excision of tumor [1,2,3,4,5]. Sci. 2020, 10, 3731 have been used with variable but limited success (skin grafts, Z-plasties, local and distant flaps) [6,7,8,9]

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Conclusion