One-Stage Skin Grafting of the Exposed Skull with Artificial Dermis after cancer removal: Long-term Experiences.

Various surgical procedures claim to show high success rate in scalp reconstruction. However, it is still difficult to cover wide range of scalp defects accompanied with skull exposure after cancer removal. Between March 2007 and March 2010, one-stage skin grafting with artificial dermis was performed in 8 patients with scalp defect accompanied with skull exposure after malignancy resection. A burr hole was made with several millimeter gap to the skull’s outer table, and thus vascular diploic space was exposed. After the application of artificial dermis to the exposed vascular diploic space, the split-thickness skin graft was performed. As artificial dermis, AlloDerm was used in 5 patients, whereas Matriderm was used in 3 patients. All patients were males, and their mean age was 60.7 years old. All patients were due to post- oncologic surgery defects. The mean defect size was 247.9 cm2. In all patients, skin graft was well taken, and radiation-induced skin defects occurred in 2 of 3 patients to whom a postoperative radiotherapy was performed but those were cured by secondary intention. Follow-up period was on average 19.6 months, and all patients demonstrated stable coverage without having complications including break down of skin graft or osteomyelitis that requires re-operation. To this end, the authors make our report on the one-stage skin grafting with artificial dermis as a reliable, simple and safe technique to cover exposed skull after cancer removal.
Source: Head and Neck Oncology - Category: Cancer & Oncology Source Type: research