Two-Stage Reconstruction of Head and Neck Defects after Tumor Resection with a Dermal Regeneration Template

Abstract

Large defects after tumor resection in the head and neck area can be reconstructed with local flaps or skin grafts or heal by secondary intention. Especially in elderly patients, a rapid procedure with an acceptable aesthetic and reliable functional outcome is required. We investigated an alternative strategy using the Integra Dermal Regeneration Template (IDRT) for the reconstruction of large defects. In 18 patients (75 ± 3 years), 19 extended head and neck defects were treated with IDRT to enhance healing. The mean defect size was 32 ± 7 cm2. The defects were transplanted within a mean postoperative time of 25 ± 2 days and overall showed good cosmetic results and stable scars. The mean follow-up time was 11 ± 1 months. Minor complications were hyperpigmentation (n = 1), small ulcus (n = 1), one minor ectropion (n = 1), and partial loss of the skin graft after immediate radiotherapy (n = 1). In one patient, the silicon layer had to be removed after 8 days owing to partial destruction of the IDRT. We observed shrinkage of 50 ± 4% within 6 months. IDRT is an alternative technique for the reconstruction of extended head and neck defects. It can be conducted without major complications and with a short healing time and acceptable cosmetic results in elderly patients.