Integra Dermal Regeneration Template: Where Does it Fit on the Reconstructive Ladder?
St Christopher's Hospital for Children, Bala Cynwyd, PA, USA.
BACKGROUND: Integra Dermal Regeneration Template (Integra Life Sciences, Plainsboro, NJ) is a skin-substitute originally invented for use in severe life-threatening burn injuries. Recently, the FDA approved Integra for use in all aspects of reconstructive surgery. The "Reconstructive Ladder" involves methods of reconstruction going from simplest to most complex for any given surgical situation. The introduction of Integra into the arena of reconstructive surgery has created another option for approaching complex surgical problems. The issued to be discussed is where does this technique fit into the standard plastic surgical teachings.
METHODS: The author has used Integra for 10 years in a variety of reconstructive situations including burn injuries, burn scar reconstruction and contracture release, giant hairy nevi, traumatic wounds, and cancer reconstruction.
RESULTS: The use of Integra in reconstruction has recently become an available option to plastic surgeons. A variety of complex wounds and other reconstructive situations (see Methods) will be presented using Integra in lieu of other surgical techniques, including situations often requiring microvascular free flap reconstruction in the past. This has allowed a simpler approach to many problems with a high rate of success and a low rate of complications.
CONCLUSIONS: The results demonstrate Integra is an excellent option for many difficult clinical problems previously requiring more complex reconstructive efforts. This secures Integra's position high up on the "Reconstructive Ladder", allowing a simpler and safe approach to many situations.