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A Full Skin Defect Model to Evaluate Vascularization of Biomaterials In Vivo

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Periocular Reconstruction Utilizing the Integra Dermal Regeneration Template.

Liane O Dallalzadeh¹, Anne L Bennett², Mikaela Kislevitz²

¹Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas.

Ophthalmic Plastic and Reconstructive Surgery

|August 20, 2025

Summary

This summary is machine-generated.

The Integra dermal regeneration template (DRT) aids periocular reconstruction after skin cancer surgery. While useful for large defects, it can lead to eyelid malposition, requiring careful patient discussion.

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Area of Science:

Ophthalmology
Dermatology
Plastic Surgery

Background:

Periocular skin cancer excision often results in complex defects requiring specialized reconstruction.
The Integra dermal regeneration template (DRT) is a bioengineered skin substitute used in various reconstructive scenarios.

Purpose of the Study:

To evaluate the efficacy and outcomes of using DRT for periocular reconstruction following Mohs or surgical excision of cutaneous malignancies.
To assess the incidence of postoperative cicatricial eyelid malposition after DRT application in the periocular region.

Main Methods:

A retrospective study was conducted on adult patients undergoing periocular reconstruction with DRT between 2017 and 2023.
Defects involved at least one periocular subunit, with primary outcome being cicatricial eyelid malposition.
Data collected included defect size, location, reasons for DRT use, re-epithelialization time, and malposition incidence.

Main Results:

Sixteen patients (mean age 70.6 years) with large periocular defects (mean 27.0 cm²) were included.
Eighty-one percent of defects involved more than one periocular subunit.
Fifty-six percent of patients developed cicatricial eyelid malposition, most commonly affecting the brow and nasal sidewall.

Conclusions:

DRT is a viable option for reconstructing extensive periocular defects after cutaneous malignancy excision, especially when margins are unclear or for specific patient factors.
The significant incidence of eyelid malposition necessitates thorough preoperative counseling for patients considering DRT reconstruction.
Further research may explore techniques to mitigate malposition risks associated with DRT in periocular reconstruction.