Alternative Reconstruction Option for Cutaneous Malignancy
Posted: Tuesday, December 10, 2019
Reconstructive surgery after skin cancer excision can be challenging for patients with cutaneous malignancies for a variety of reasons. They include the extent of resection, preclusive factors for general anesthesia, protracted procedure time, reluctance for additional donor-site wound, and personal choice. Current treatment options have their advantages but also limitations. Dermal substitutes such as a human acellular dermal matrix, which were initially used to treat burns, are being considered as an alternative to autologous skin grafts. Their use seems to be associated with little donor-site morbidity and comparable outcomes similar to autologous skin grafting.
Rachel E. Lewis, MD, of Hackensack University Medical Center, New Jersey, and colleagues conducted a retrospective review in 228 patients with cutaneous malignancy between 2012 and 2018. Their results were published in The American Surgeon.
Of the participants, 151 were male, and 77 were female. The median age was 72 years (range, 29–95 years). They evaluated defect characteristics, healing time, postoperative outcomes, and patient demographics. With regard to diagnosis, 113 patients (49.6%) presented with melanoma; 61 patients (26.8%), with squamous cell carcinoma; and 28 patients (12.2%), with basal cell carcinoma.
Participants in the study received a human acellular dermal matrix (a soft connective tissue graft that works by providing a scaffold to integrate and revascularize donor cells) after skin cancer excision. The average time to complete epidermal coverage was 42 days. Graft failure occurred in six patients (2.6%).
“Acellular dermal matrix is a viable, low-morbid alternative for reconstruction of defects secondary to skin cancer excision, with no donor-site morbidity,” concluded the investigators.
Disclosure: For full disclosures of the study authors, visit ingentaconnect.com.