EplastyPub Date : 2022-08-02eCollection Date: 2022-01-01
Shannon S Wu, Michael Wells, Mona Ascha, Radhika Duggal, James Gatherwright, Kyle Chepla
{"title":"生物可降解基质与胶原-软骨素有机硅双分子层头颈部创面重建。","authors":"Shannon S Wu, Michael Wells, Mona Ascha, Radhika Duggal, James Gatherwright, Kyle Chepla","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Head and neck reconstruction is challenging because of the functional requirements of movement, sensation, and cosmesis of this highly visible region. This study is the first to compare Novosorb biodegradable temporizing matrix (BTM) and Integra collagen-chondroitin silicone (CCS) skin substitutes for reconstruction of soft tissue head and neck wounds.</p><p><strong>Methods: </strong>This retrospective review included adults who underwent wound reconstruction of the head/neck with either BTM or CCS between 2015 and 2020. Patient-level data, complications, and closure rates were compared.</p><p><strong>Results: </strong>The review identified 15 patients: 5 who received BTM and 10 who received CCS. Mean age at dermal template placement was 55 (range, 28-79) years. Race, sex, smoking status, medical comorbidities, defect size, radiation history, prior surgeries, and follow-up time were not significantly different between groups. Wound etiologies for BTM and CCS included burn (40% vs 60%), trauma (20% vs 20%), surgical wounds (20% vs 20%), and skin cancer (20% vs 0%), respectively (<i>P</i> = .026). Skin grafts were placed in 8 (80%) wounds after CCS placement, compared with 3 (60%) after BTM (<i>P</i> = .670). Template reapplication was required in 2 (40%) BTM wounds and 3 (30%) CCS wounds (<i>P</i> = 1.0). Infection, hematoma, and seroma were comparable between groups, although skin graft failure was higher in the CCS group at 3 (37.5%) compared with 0 for BTM (<i>P</i> = .506). More secondary procedures were required after CCS placement (CCS, 1.9 ± 2.2; BTM, 0.9 ± 0.8; <i>P</i> = .090). Definitive closure in patients not lost to follow-up occurred in 4 (100%) BTM and 6 (75%) CCS cases (<i>P</i> = 1.0).</p><p><strong>Conclusions: </strong>Head and neck wounds treated with BTM had comparable closure and complication rates as CCS bilayer and required fewer secondary procedures and skin grafts. These findings suggest that BTM is safe and efficacious for application in head and neck wounds and may be considered as an economical alternative.</p>","PeriodicalId":11687,"journal":{"name":"Eplasty","volume":" ","pages":"e31"},"PeriodicalIF":0.0000,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361342/pdf/eplasty-22-e31.pdf","citationCount":"0","resultStr":"{\"title\":\"Head and Neck Wound Reconstruction Using Biodegradable Temporizing Matrix Versus Collagen-Chondroitin Silicone Bilayer.\",\"authors\":\"Shannon S Wu, Michael Wells, Mona Ascha, Radhika Duggal, James Gatherwright, Kyle Chepla\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Head and neck reconstruction is challenging because of the functional requirements of movement, sensation, and cosmesis of this highly visible region. This study is the first to compare Novosorb biodegradable temporizing matrix (BTM) and Integra collagen-chondroitin silicone (CCS) skin substitutes for reconstruction of soft tissue head and neck wounds.</p><p><strong>Methods: </strong>This retrospective review included adults who underwent wound reconstruction of the head/neck with either BTM or CCS between 2015 and 2020. Patient-level data, complications, and closure rates were compared.</p><p><strong>Results: </strong>The review identified 15 patients: 5 who received BTM and 10 who received CCS. Mean age at dermal template placement was 55 (range, 28-79) years. Race, sex, smoking status, medical comorbidities, defect size, radiation history, prior surgeries, and follow-up time were not significantly different between groups. Wound etiologies for BTM and CCS included burn (40% vs 60%), trauma (20% vs 20%), surgical wounds (20% vs 20%), and skin cancer (20% vs 0%), respectively (<i>P</i> = .026). Skin grafts were placed in 8 (80%) wounds after CCS placement, compared with 3 (60%) after BTM (<i>P</i> = .670). Template reapplication was required in 2 (40%) BTM wounds and 3 (30%) CCS wounds (<i>P</i> = 1.0). Infection, hematoma, and seroma were comparable between groups, although skin graft failure was higher in the CCS group at 3 (37.5%) compared with 0 for BTM (<i>P</i> = .506). More secondary procedures were required after CCS placement (CCS, 1.9 ± 2.2; BTM, 0.9 ± 0.8; <i>P</i> = .090). Definitive closure in patients not lost to follow-up occurred in 4 (100%) BTM and 6 (75%) CCS cases (<i>P</i> = 1.0).</p><p><strong>Conclusions: </strong>Head and neck wounds treated with BTM had comparable closure and complication rates as CCS bilayer and required fewer secondary procedures and skin grafts. These findings suggest that BTM is safe and efficacious for application in head and neck wounds and may be considered as an economical alternative.</p>\",\"PeriodicalId\":11687,\"journal\":{\"name\":\"Eplasty\",\"volume\":\" \",\"pages\":\"e31\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361342/pdf/eplasty-22-e31.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eplasty\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eplasty","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:头颈部重建是具有挑战性的,因为这一高度可见区域的运动,感觉和外观的功能要求。本研究首次比较了Novosorb可生物降解暂存基质(BTM)和Integra胶原-软骨素硅酮(CCS)皮肤替代品在头颈部软组织创伤重建中的应用。方法:本回顾性研究包括2015年至2020年期间使用BTM或CCS进行头颈部伤口重建的成年人。比较患者水平数据、并发症和闭合率。结果:本综述共纳入15例患者,其中5例接受BTM, 10例接受CCS。真皮模板放置的平均年龄为55岁(范围28-79岁)。种族、性别、吸烟状况、合并症、缺陷大小、放射史、既往手术和随访时间在组间无显著差异。BTM和CCS的伤口病因分别为烧伤(40% vs 60%)、创伤(20% vs 20%)、手术伤口(20% vs 20%)和皮肤癌(20% vs 0%) (P = 0.026)。术后创面植皮8例(80%),BTM创面植皮3例(60%)(P = 0.670)。2例(40%)BTM创面和3例(30%)CCS创面需要重新应用模板(P = 1.0)。感染、血肿和血肿在两组间具有可比性,尽管CCS组植皮失败发生率为3(37.5%),而BTM组为0 (P = .506)。放置CCS后需要更多的二次手术(CCS, 1.9±2.2;Btm, 0.9±0.8;P = .090)。4例(100%)BTM病例和6例(75%)CCS病例(P = 1.0)未丢失随访的患者最终痊愈。结论:BTM治疗头颈部伤口具有与CCS双分子层相当的闭合性和并发症发生率,并且需要较少的二次手术和皮肤移植。这些结果表明,BTM在头颈部伤口的应用是安全有效的,可以被认为是一种经济的替代方法。
Head and Neck Wound Reconstruction Using Biodegradable Temporizing Matrix Versus Collagen-Chondroitin Silicone Bilayer.
Background: Head and neck reconstruction is challenging because of the functional requirements of movement, sensation, and cosmesis of this highly visible region. This study is the first to compare Novosorb biodegradable temporizing matrix (BTM) and Integra collagen-chondroitin silicone (CCS) skin substitutes for reconstruction of soft tissue head and neck wounds.
Methods: This retrospective review included adults who underwent wound reconstruction of the head/neck with either BTM or CCS between 2015 and 2020. Patient-level data, complications, and closure rates were compared.
Results: The review identified 15 patients: 5 who received BTM and 10 who received CCS. Mean age at dermal template placement was 55 (range, 28-79) years. Race, sex, smoking status, medical comorbidities, defect size, radiation history, prior surgeries, and follow-up time were not significantly different between groups. Wound etiologies for BTM and CCS included burn (40% vs 60%), trauma (20% vs 20%), surgical wounds (20% vs 20%), and skin cancer (20% vs 0%), respectively (P = .026). Skin grafts were placed in 8 (80%) wounds after CCS placement, compared with 3 (60%) after BTM (P = .670). Template reapplication was required in 2 (40%) BTM wounds and 3 (30%) CCS wounds (P = 1.0). Infection, hematoma, and seroma were comparable between groups, although skin graft failure was higher in the CCS group at 3 (37.5%) compared with 0 for BTM (P = .506). More secondary procedures were required after CCS placement (CCS, 1.9 ± 2.2; BTM, 0.9 ± 0.8; P = .090). Definitive closure in patients not lost to follow-up occurred in 4 (100%) BTM and 6 (75%) CCS cases (P = 1.0).
Conclusions: Head and neck wounds treated with BTM had comparable closure and complication rates as CCS bilayer and required fewer secondary procedures and skin grafts. These findings suggest that BTM is safe and efficacious for application in head and neck wounds and may be considered as an economical alternative.