Biomaterial Appears Useful in Certain Head and Neck Surgery Wound Repairs

Future Uses

Looking to the future, Dr. Saigal predicted that the Integra template would find uses in head and neck surgery in such areas as nasal reconstruction, where there is nasal vestibular stenosis; in cases where the internal nasal lining has been destroyed or is compromised; and in repairing forehead flap donor site wounds. He said that Integra templates could also help in the repair of radial arm free flap donor sites and the material would be helpful in closing large neck wounds that are resistant to repair.

In reviewing treatments for radiated scalp wounds, Dr. Saigal found a high rate of complications in patients who underwent split-thickness skin grafts. However, patients with similar wounds had better results in case series with Integra. He cited studies that showed that when combined with vacuum-assisted closure dressing in complicated wounds-wounds that included exposure to the bone and tendon-Integra application resulted in a 96% split-thickness skin graft take rate after an average of 7.25 days. Another study suggested that when combined with fibrin glue, the take rate increased to 98% at 10 days compared with a 78% take rate among controls. Skin graft transplantation was possible in an average of 11 days with Integra, compared with 24 days for controls.

Dr. Saigal observed that there are also possible downsides with the new product, including the requirement for possible staged procedures; the need to keep the wound dry for four to six weeks; the cost of the material-an 8-by-10 inch sheet of the material may cost as much as $2,000; the short one- to three-week shelf life; and the potential of introducing undetected pathogens or allergic reactions to bovine collagen-although none have been reported. He did not report any conflict of interest in regard to his presentation.

©2007 The Triological Society