Experience of Integra(®) in cancer reconstructive surgery

Objectives: Integra® has already established its role in acute burn injuries and scar management. It can also be used to cover non-vascularised wounds such as exposed bone resulting from trauma or tumour resection. The aim of this series was to review all cases that underwent Integra® reconstruction following cancer excision. In particular we were interested in the use of Integra for day-case and local anaesthetic procedures in cases where excision was required down to bone or tendon.

Methods: All patients who had Integra reconstruction over a three-year period were prospectively followed. A total of 14 cases were identified for inclusion into the series. In each case patient factors such peripheral vascular disease, age and patient choice meant that traditional methods of reconstruction were not possible. As a result a staged Integra® reconstruction was performed.

Results: The 14 cases comprised 11 (78%) males and 3 (22%) females with the majority being diagnosed with Squamous cell carcinomas, 3 (40%) or Malignant Melanomas, 3 (20%). The most common operative sites were digital (5) and scalp (6) in 72% of the cases. The average graft take was 87%. There were 4 early, 4 delayed and 3 late complications in a total of 8 patients mostly resulting in a delay in healing. In 6/14 patients (43%) there were no complications.

Conclusions: Tumour excision and wide local excision may leave patients with defects requiring complex reconstructive surgery. The options available are often compounded by various patient factors. In complex cases we have found the use of Integra® to be a safe and viable alternative to traditional methods of wound closure.