chondroitin-sulfates and Carcinoma--Basal-Cell

Describe a novel two-stage orbital exenteration technique using an INTEGRA dermal regeneration matrix.. A 63-year-old Hispanic male presented with multiple invasive right eyelid masses that incisional biopsy revealed was infiltrative basal cell carcinoma. The patient underwent a right orbital exenteration without lid sparing. An INTEGRA graft was sutured in place to cover the defect at the time of surgery and allowed to vascularize for 3 weeks. During this time, frozen section of tumor margins previously read as negative were found to have invasive basal cell carcinoma on permanent section re-evaluation. Three weeks after the initial exenteration, the patient returned to the operating room and the dermal matrix of the INTEGRA graft was found to be well integrated and vascularized. Further resection was performed in the areas which were found to have residual cancer on permanent section evaluation. After preliminary frozen section pathology demonstrated clear margins, full-thickness skin grafts harvested from the right and left supraclavicular regions were thinned, draped, and fixated over the INTEGRA matrix.. The patient recovered well and experienced no immediate postoperative complications. Adjuvant radiotherapy began 5 weeks after initial exenteration with a fully epithelized exenterated socket. At postoperative week 16, our patient remained with full epithelization after completing radiation. As of postoperative week 47, our patient has had no complications.. The use of INTEGRA with full-thickness skin grafting for orbital exenteration reconstruction presents several advantages over traditional reconstruction approaches including: quicker recovery, tumor surveillance by re-examining edges of the resection after INTEGRA dermal placement, easier postoperative care, and earlier initiation of radiation therapy.

Topics: Carcinoma, Basal Cell; Chondroitin Sulfates; Collagen; Humans; Male; Middle Aged; Orbit Evisceration; Orbital Neoplasms; Plastic Surgery Procedures; Skin Transplantation; Treatment Outcome

In 2010 excellent aesthetic results after basal cell carcinoma excision and one-stage coverage with Integra without split thickness skin graft (STSG) were published in a series of 10 Asian patients. Our aim in this study was to verify these results in a series of Caucasian patients and evaluate this procedure as a possible new standard.. 6 patients with facial basal cell carcinoma were treated by regular excision with 3 mm safety margins and one-stage coverage with Integra without STSG, followed by a clinical evaluation and fotodocumentation.. In 3 patients local infection occurred with a complete loss of the Integra. 2 out of these 3 patients showed an unaesthetic scar and are considering another surgical approach for correction. The other 3 patients had an uneventful course, unfortunately 2 out of these patients (67%) developed an unaesthetic scar as well and are also considering surgical correction.. Because of aesthetically unsatisfactory results and high infection rates we abandoned this procedure after 6 patients only. Our standard remains excision with 3 mm safety margins, histological analysis and one-stage repair with local facial flaps.

Topics: Adult; Aged; Carcinoma, Basal Cell; Chondroitin Sulfates; Cicatrix; Collagen; Facial Neoplasms; Female; Follow-Up Studies; Humans; Male; Microsurgery; Middle Aged; Plastic Surgery Procedures; Postoperative Complications; Skin Neoplasms; Skin Transplantation; Surgical Wound Infection

Integra dermal regeneration template - a two-stage, tissue-engineered, artificial skin - was introduced in the UK in May 1996. There were no restrictions on clinical application and a series of applications in reconstructive surgery were undertaken. One case involved a Caucasian lady with a nose tip basal cell carcinoma (BCC) who had a single-stage reconstruction. The 6-year follow-up was remarkable as it showed a scarless repair.. We undertook a clinical evaluation to explore the outcome of one-stage Integra reconstruction in a selected series of Chinese patients.. Ten patients (five male and five female; age range: 54-86 years) with complicated or atypical cutaneous lesions involving the head and neck were treated in an outpatient setting.. Pathology revealed eight BCCs, one squamous cell carcinoma (SCC) and one seborrhoeic keratosis. Healing took place either by wound contraction alone or in conjunction with re-epithelialisation. All wounds were fully healed within 6 weeks. Follow-up ranged from 18 to 30 months, and there has been no recurrence of the malignant lesions.. In selected cases, one-stage reconstruction using Integra can reduce operating time with no delay for frozen section, flap raising or graft harvesting. More immediate postoperative care is needed, but the long-term aesthetic results are uniformly acceptable.

Topics: Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Chondroitin Sulfates; Collagen; Female; Head and Neck Neoplasms; Humans; Keratosis, Seborrheic; Male; Middle Aged; Nose Diseases; Skin Neoplasms; Wounds and Injuries

Large, full-thickness calvarial defects present a series of significant reconstructive challenges involving a range of techniques, including local and free flaps. Occasionally these conventional methods may not be possible due to technical, or patient, factors. Artificial dermis is already widely used in burns surgery and is increasing in oncological reconstruction. We believe that artificial dermis coupled with split-thickness skin grafting provides an excellent option for closure of these defects when other techniques are not appropriate.

Topics: Aged, 80 and over; Carcinoma, Basal Cell; Chondroitin Sulfates; Collagen; Female; Head and Neck Neoplasms; Humans; Neoplasm Recurrence, Local; Scalp; Skin Neoplasms; Skin Transplantation; Skin, Artificial; Skull

Topics: Carcinoma, Basal Cell; Chondroitin Sulfates; Collagen; Facial Neoplasms; Female; Forehead; Humans; Middle Aged; Mohs Surgery; Plastic Surgery Procedures; Skin Neoplasms; Skin, Artificial

Topics: Adult; Aged; Biocompatible Materials; Carcinoma, Basal Cell; Chondroitin Sulfates; Collagen; Female; Humans; Male; Melanoma; Middle Aged; Nose; Nose Neoplasms; Skin Transplantation; Skin, Artificial; Wound Healing

Topics: Adult; Aged; Biocompatible Materials; Carcinoma, Basal Cell; Chondroitin Sulfates; Collagen; Ear; Humans; Male; Plastic Surgery Procedures; Skin Neoplasms; Skin, Artificial