Abstract：
Integra® (Integra LifeSciences) is a well-known dermal regeneration template used in partial and full-thickness wound reconstruction. It can be applied directly on to vascular tissue to create a bed for a skin graft, which is often placed in a second surgery. We present our experience of its novel use in oral and maxillofacial surgery patients, using it directly on bone and cartilage (avascular tissue) without further skin grafting. Patients who required full-thickness excision of lesions down to bone or cartilage and who were treated using Integra® were included. After scalp or ear lesion resection, the collagenous dermal layer of Integra® was placed directly on to bone or cartilage and, along with its outer silicone epidermal layer, secured to the defect with absorbable sutures and a bolster dressing. The wounds were kept dry for 14 days, at which point the dressing and silicone were removed and patients continued regular wound care. Seventeen patients were included, 15 of whom had squamous cell carcinoma. One was lost to follow up. The rest achieved complete healing of the defect. Histology showed epidermis developing on the Integra® surface and at one year, the appearance of normal scarred skin. This novel approach could redefine the uses of Integra®, avoiding the need for free-flap surgery or skin grafting when reconstructing large defects. Further resection of close margins or recurrence is easier after reconstruction using dermal regeneration material than after reconstruction with a local or free flap.
摘要：
Integra®(IntegraLifeSciences)是用于部分和全厚度伤口重建的众所周知的真皮再生模板。它可以直接应用于血管组织上，为皮肤移植创建床，通常在第二次手术中进行。我们介绍了我们在口腔颌面外科患者中新颖使用它的经验，直接在骨骼和软骨（无血管组织）上使用它，而无需进一步的皮肤移植。包括需要全层切除病变直至骨或软骨并使用Integra®治疗的患者。头皮或耳部病变切除后，将Integra®的胶原真皮层直接放置在骨骼或软骨上，连同它的外硅胶表皮层，用可吸收缝线和垫层敷料固定在缺损处。伤口保持干燥14天，此时，敷料和硅胶被移除，患者继续定期伤口护理。包括17名患者，其中15人患有鳞状细胞癌。一个人失去了跟进。其余的则完全治愈了缺损。组织学显示表皮在Integra®表面发育，一年后，正常疤痕皮肤的外观。这种新颖的方法可以重新定义Integra®的用途，在重建大型缺损时，避免了游离皮瓣手术或植皮的需要。使用真皮再生材料重建后比使用局部或游离皮瓣重建后更容易进一步切除近缘或复发。
