Vacuum-assisted closure device and skin substitutes for complex Mohs defects
Teresa Cunningham1, Malcolm Marks
1*Both the authors are affiliated with the Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston Salem, North Carolina.
Summary
Acellular dermal regeneration template (ADRT) combined with negative-pressure wound therapy (NPWT) and skin grafting offers a viable reconstructive option for complex defects. This approach provides satisfactory functional and aesthetic outcomes for patients with skin cancer.
Area of Science:
- Dermatologic surgery
- Reconstructive surgery
- Wound healing
Background:
- Dermatologic malignancies can create challenging soft tissue defects, especially when vital structures are exposed.
- Traditional reconstructive options like tissue transfer may not be suitable for all patients, particularly those with comorbidities.
- Acellular dermal regeneration template (ADRT) with split-thickness skin grafting (STSG) has emerged as a promising alternative.
Observation:
- This study evaluated the use of ADRT combined with negative-pressure wound therapy (NPWT) for reconstructing complex defects on the scalp and feet.
- Two patients with squamous cell carcinoma underwent wide local excision.
- ADRT and NPWT were applied, followed by STSG 7-10 days later.
Findings:
- Both patients achieved successful skin graft integration and complete wound healing.
- No local recurrence of the malignancy was observed.
- The reconstructive outcomes were both functionally and aesthetically satisfactory.
Implications:
- ADRT with NPWT and STSG presents an effective alternative to traditional tissue transfer methods for complex Mohs defects.
- This technique may expand reconstructive possibilities for patients with skin cancer who are poor surgical candidates.
- Further research could explore the long-term efficacy and broader applications of this combined approach.
