Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Surgery Research and Practice Pub Date : 2019-10-09 DOI:10.1155/2019/9483627

Jude L. Opoku-Agyeman, Kayla Humenansky, W. Davis, P. Glat

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引用次数: 4

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.

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使用Integra重建痣切除术后:系统回顾和汇总分析报告病例

背景Integra真皮重建模板已成为先天性痣切除术后创面重建的一种选择，尤其是巨大的先天性痣。在文献中有许多关于Integra用于此目的的报告。本系统综述汇总分析了目前关于先天性痣切除术后Integra应用的文献，包括患者特征和报道的结果。方法使用PubMed、Ovid、Embase和Cochrane图书馆数据库进行系统的电子检索，检索报道使用Integra修复痣切除后缺损的研究。对符合纳入标准的研究进行分析。进行合并描述性统计。结果符合纳入标准的13项研究纳入分析，在31例患者中产生31种手术。13项研究中的11项是代表31名患者中的17名的病例报告。一项研究是回顾性的，另一项研究是前瞻性的。平均随访2.67年(0.2-13年)。整体伤口愈合率为100%。整体初始Integra取药率为90.3%，植皮取药率为100%。并发症发生率为14.8%。患者平均年龄7.36岁。痣平均大小为6.29% TBSA(范围0.005% ~ 26%)，最终植皮时间3.28周。在已发表的研究中发现显著的异质性。结论对于身体大部分不同大小的先天性痣原发或继发切除后的缺损重建，应用Integra是一种安全可行的选择。为了充分估计并发症的发生率，需要长期随访研究和前瞻性队列研究。然而，这种情况的罕见性使得这些类型的研究非常困难。

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Surgery Research and Practice

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期刊介绍： Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.