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Review
. 2022 Apr 12;36(1):43-47.
doi: 10.1055/s-0042-1744282. eCollection 2022 Feb.

Use of Biologic Agents in Extremity Reconstruction

Andrew E Grush  1   2 , Monal Depani  3 , Matthew J Parham  1   2 , Valeria Mejia-Martinez  3 , Alexandra Thornton  3 , Douglas M Sammer  3
Affiliations
Review

Use of Biologic Agents in Extremity Reconstruction

Andrew E Grush et al. Semin Plast Surg. .

Abstract

Skin and soft tissue defects of the lower extremity present a unique challenge for the reconstructive surgeon. Successful repair of the lower extremity relies not only on strong anatomical knowledge and surgical expertise, but also on careful consideration of the numerous preoperative factors and indications that may alter the patient's response to operative management. While many of these injuries result from burns, avulsive trauma, diabetes, or vascular insufficiencies, a significant portion can be associated with resection of neoplastic pathologies. This review outlines the uses, indications, and considerations for biologic wound agents in reconstructing skin and soft tissue defects of the lower extremity following Mohs micrographic surgery.

Keywords: Integra; Mohs micrographic surgery; cutaneous malignancies; fasciocutaneous flap; lower extremity; melanoma.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Use of Integra to reconstruct a post-ablative defect of the posterior leg and thigh following resection of a large squamous cell carcinoma in a 35-year-old male. Preoperative photography ( A ), 90 days postoperatively demonstrating complete take of Integra ( B ), definitive reconstruction of the leg defect with STSG at 90 days postoperatively ( C ).
Fig. 2
Fig. 2
Use of Integra to reconstruct a post-ablative defect of the heel following resection of a melanoma in a 66-year-old female. Photograph of post-ablative defect ( A ), 8 weeks following placement of Integra ( B ), 5 months following placement of Integra ( C ).
Fig. 3
Fig. 3
Use of Integra to reconstruct a post-ablative defect of the great toe following resection of an ungual melanoma in a 72-year-old male. Photograph of post-ablative defect ( A ), percutaneous pin fixation with Kirshner wire used to stabilize the joint laxity that occurred secondarily to tumor excision ( B ), 25 days following placement of Integra ( C ), placement of STSG 25 days after initial excision and placement of Integra ( D,E )
See this image and copyright information in PMC

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References

    1. Rogers H W, Weinstock M A, Feldman S R, Coldiron B M. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the U.S. population, 2012. JAMA Dermatol. 2015;151(10):1081–1086. - PubMed
    1. Ferry A M, Sarrami S M, Hollier P C, Gerich C F, Thornton J F. Treatment of non-melanoma skin cancers in the absence of Mohs micrographic surgery. Plast Reconstr Surg Glob Open. 2020;8(12):e3300. - PMC - PubMed
    1. Hutchinson B L. Malignant melanoma in the lower extremity. A comprehensive overview. Clin Podiatr Med Surg. 1986;3(03):533–550. - PubMed
    1. Durbec F, Martin L, Derancourt C, Grange F. Melanoma of the hand and foot: epidemiological, prognostic and genetic features. A systematic review. Br J Dermatol. 2012;166(04):727–739. - PubMed
    1. Juzeniene A, Baturaite Z, Moan J. Sun exposure and melanomas on sun-shielded and sun-exposed body areas. Adv Exp Med Biol. 2014;810:375–389. - PubMed