The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported
Introduction Autologous tissue transfers have been used in chest wall reconstruction for decades, with high morbidity. Recently, acellular dermal matrices (ADMs) have emerged as an alternative. The aim of this article is to report our initial experience in the reconstruction of malformative chest wa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2022-07-01
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| Series: | The Surgery Journal |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1755622 |
| _version_ | 1798039925127380992 |
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| author | Carlos Delgado-Miguel Miriam Miguel-Ferrero Antonio Muñoz-Serrano Mercedes Díaz Juan Carlos López-Gutiérrez Carlos De la Torre |
| author_facet | Carlos Delgado-Miguel Miriam Miguel-Ferrero Antonio Muñoz-Serrano Mercedes Díaz Juan Carlos López-Gutiérrez Carlos De la Torre |
| author_sort | Carlos Delgado-Miguel |
| collection | DOAJ |
| description | Introduction Autologous tissue transfers have been used in chest wall reconstruction for decades, with high morbidity. Recently, acellular dermal matrices (ADMs) have emerged as an alternative. The aim of this article is to report our initial experience in the reconstruction of malformative chest wall deformities with ADM.
Methods A prospective observational study was performed in patients with malformative chest wall deformities, who were reconstructed with ADM at our institution between 2018 and 2020. We analyzed demographic variables, surgical features, postoperative complications, and cosmetic results at 12 months' follow- up.
Results Four male patients were included (median age: 16 years). Two patients had bilateral costal anomalies, one patient had a unilateral chest deformity, and one patient had Poland syndrome. In all patients, blunt dissection of the subcutaneous cellular tissue overlying the defect was performed through 2.5 to 3 cm skin incisions, creating a pouch. Afterwards, several sheets of Integra Single Layer were placed in the pouch, to replace the volume defect. All patients were discharged same-day. No postoperative infections, hematomas, or seromas were observed. Only one patient presented with a partial surgical wound dehiscence. Revisions were performed at 1, 3, 6, and 12 months. All 4 patients were satisfied with the cosmetic outcome (Nuss Questionnaire: median score: 16 points; Q1–Q3: 22–26).
Conclusion The use of ADM in malformative chest wall deformities reconstruction has not been previously described in children. This study demonstrates that the use of ADM is a safe and reliable technique. However, more studies with long-term follow-up are warranted. |
| first_indexed | 2024-04-11T22:00:25Z |
| format | Article |
| id | doaj.art-6de5fd860ab0433691d179f022e214fe |
| institution | Directory Open Access Journal |
| issn | 2378-5128 2378-5136 |
| language | English |
| last_indexed | 2024-04-11T22:00:25Z |
| publishDate | 2022-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | The Surgery Journal |
| spelling | doaj.art-6de5fd860ab0433691d179f022e214fe2022-12-22T04:00:57ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362022-07-010803e187e19110.1055/s-0042-1755622The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series ReportedCarlos Delgado-Miguel0Miriam Miguel-Ferrero1Antonio Muñoz-Serrano2Mercedes Díaz3Juan Carlos López-Gutiérrez4Carlos De la Torre5Department of Pediatric Surgery, La Paz Children's Hospital, Madrid, SpainDepartment of Pediatric Plastic Surgery, La Paz Children's Hospital, Madrid, SpainDepartment of Pediatric Surgery, La Paz Children's Hospital, Madrid, SpainDepartment of Pediatric Plastic Surgery, La Paz Children's Hospital, Madrid, SpainDepartment of Pediatric Plastic Surgery, La Paz Children's Hospital, Madrid, SpainDepartment of Pediatric Surgery, La Paz Children's Hospital, Madrid, SpainIntroduction Autologous tissue transfers have been used in chest wall reconstruction for decades, with high morbidity. Recently, acellular dermal matrices (ADMs) have emerged as an alternative. The aim of this article is to report our initial experience in the reconstruction of malformative chest wall deformities with ADM. Methods A prospective observational study was performed in patients with malformative chest wall deformities, who were reconstructed with ADM at our institution between 2018 and 2020. We analyzed demographic variables, surgical features, postoperative complications, and cosmetic results at 12 months' follow- up. Results Four male patients were included (median age: 16 years). Two patients had bilateral costal anomalies, one patient had a unilateral chest deformity, and one patient had Poland syndrome. In all patients, blunt dissection of the subcutaneous cellular tissue overlying the defect was performed through 2.5 to 3 cm skin incisions, creating a pouch. Afterwards, several sheets of Integra Single Layer were placed in the pouch, to replace the volume defect. All patients were discharged same-day. No postoperative infections, hematomas, or seromas were observed. Only one patient presented with a partial surgical wound dehiscence. Revisions were performed at 1, 3, 6, and 12 months. All 4 patients were satisfied with the cosmetic outcome (Nuss Questionnaire: median score: 16 points; Q1–Q3: 22–26). Conclusion The use of ADM in malformative chest wall deformities reconstruction has not been previously described in children. This study demonstrates that the use of ADM is a safe and reliable technique. However, more studies with long-term follow-up are warranted.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1755622minimally invasive surgerychest wall deformitieschildrenpoland syndrome |
| spellingShingle | Carlos Delgado-Miguel Miriam Miguel-Ferrero Antonio Muñoz-Serrano Mercedes Díaz Juan Carlos López-Gutiérrez Carlos De la Torre The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported The Surgery Journal minimally invasive surgery chest wall deformities children poland syndrome |
| title | The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported |
| title_full | The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported |
| title_fullStr | The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported |
| title_full_unstemmed | The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported |
| title_short | The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported |
| title_sort | use of acellular dermal matrix integra single layer for the correction of malformative chest wall deformities first case series reported |
| topic | minimally invasive surgery chest wall deformities children poland syndrome |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1755622 |
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