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

Abstract

Background: 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. Objective: We investigated an alternative strategy using the Integra Dermal Regeneration Template (IDRT) for the reconstruction of large defects. Methods: In 18 patients (75 ± 3 years), 19 extended head and neck defects were treated with IDRT to enhance healing. Results: 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. Conclusion: 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.