Abstract
Background The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes. Methods Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled descriptive statistics were performed. Results Thirteen studies that met the inclusion criteria were included for analysis, yielding 31 procedures in 31 patients. Eleven of the thirteen studies were case reports representing 17 of the 31 patients. One study was retrospective, and the other study was a prospective study. The mean follow-up was 2.67 years (range, 0.2–13 years). The overall wound closure rate was 100%. The overall initial Integra take rate was 90.3% and the skin graft take rate was 100%. The rate of reported complications was 14.8%. The average age of patients was 7.36 years. The average size of the nevus was 6.29% TBSA (range, 0.005%–26%), and the time to definitive skin grafting was 3.28 weeks. Significant heterogeneity was found among the published studies. Conclusion We conclude that the use of Integra appears to be a safe and viable option for defect reconstruction after the primary or secondary excision of congenital nevi of different sizes and on most parts of the body. Long-term follow-up studies and prospective cohort studies are required in order to fully estimate the incidence of complications. However, the rarity of this condition make these types of studies very difficult.
Highlights
Congenital melanocytic nevi (CMN) are benign proliferations of melanocytic cells in the epidermis or dermis. e estimated incidence of CMN in the general population is in the vicinity of 1 to 2 percent [1]. e incidence of giant hairy melanocytic melanoma, a subset of CMN, is even rarer
Some of the reported advantages of Integra include less donor site morbidity compared to full-thickness skin grafting (FTSG), split-thickness skin grafting (STSG), and major flap reconstruction as well as decreased rate of wound contracture and hypertrophic scars. e purpose of this study was to review the current literature on the use of Integra for reconstruction after resection of CMN and to analyze patient characteristics and outcomes using pooled data analysis
Discussion is literature review included 13 unique studies yielding 31 procedures involving the application of Integra after resection of congenital nevi. e data extracted in the review is best estimated from large prospective studies; these data are rare. e first reported case of Integra for this purpose was in 2003 by Kopp et al [11, 12]
Summary
Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases. Ere have been many reports on Integra use in the literature for this purpose. Is systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes. Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Irteen studies that met the inclusion criteria were included for analysis, yielding 31 procedures in 31 patients. We conclude that the use of Integra appears to be a safe and viable option for defect reconstruction after the primary or secondary excision of congenital nevi of different sizes and on most parts of the body. The rarity of this condition make these types of studies very difficult
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