Summary
Background
Soft tissue deficits associated with exposed tendon and absent paratenon pose difficult
reconstructive problems due to tendon adhesions, poor range of motion, poor cosmesis,
and donor site morbidity. Integra Bilayer Matrix Wound Dressing (Integra Lifesciences
Corp Plainsboro, NJ) is a skin substitute widely used in reconstructive surgery, including
the incidental coverage of tendons. However, Integra's post-operative functionality
of the tendons has not been well documented. We report the results of using Integra
for soft tissue reconstruction overlying tendons with loss of paratenon in upper and
lower extremity soft tissue defects. Methods: Forty-two patients (35 men and 7 women)
with exposed tendons due to trauma (37), cancer excision (2) or chronic wounds (3)
were reconstructed using Integra. Results were compiled in a prospective manner, including
age, gender, wound location, wound size, time to final closure, operative time, follow-up
length, split-thickness skin graft percentage take and active post-operative range
of motion. Likewise using Medline, a literature search of current surgical techniques
for the treatment of exposed tendons and the results from the literature were compared
with these study results. Results: All patients healed with an average split-thickness
skin graft take rate of 92.5% ± 6.1 (range, 80–100%). The thirty-two patients not
lost to follow-up achieved an average range of motion of 91.2% ± 6.5 (range, 80–100%).
Conclusion: Integra offers a convenient, efficient operative procedure with minimal
morbidity, demonstrating good cosmesis and tendon function. Thus, Integra may offer
an alternative option for immediate tendon coverage in both the upper and lower extremities.
Keywords
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Article info
Publication history
Published online: June 22, 2012
Accepted:
May 26,
2012
Received:
October 17,
2011
Footnotes
☆The content of this paper has been presented at the California Society of Plastic Surgeons, 2008; American College of Surgeons Southern California Chapter, 2007; Annual Post-Graduate Convention Loma Linda University Medical School, 2007.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
