S A Kolenik1, D J Leffell. 1. Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Abstract
BACKGROUND: Immediate reconstruction has become the preferred approach to management of full-thickness cutaneous defects following microscopically controlled excision (MCE) of tumors. In a minority of patients, however, large reconstructive procedures are contraindicated, and a long-term biological dressing that stimulates healing while minimizing wound care is desirable. OBJECTIVE: To assess the utility of cryopreserved human skin allografts (HSA) in wound care and wound healing following Mohs surgery. METHODS: Sixteen patients were treated with HSA following MCE and followed postoperatively for evidence of infection, involution, or survival of HSA, and granulation tissue production. Follow-up was 2-26 months. RESULTS: The use of HSA resulted in one of three general outcomes: rapid healing and rejection, subsequent full-thickness skin grafting, or persistence of HSA during prolonged healing. CONCLUSIONS: HSA are a safe alternative to immediate reconstruction in a carefully selected population of skin cancer patients. They minimize wound care while providing continuous wound coverage during healing, and are an efficient bridge to full-thickness skin grafting.
BACKGROUND: Immediate reconstruction has become the preferred approach to management of full-thickness cutaneous defects following microscopically controlled excision (MCE) of tumors. In a minority of patients, however, large reconstructive procedures are contraindicated, and a long-term biological dressing that stimulates healing while minimizing wound care is desirable. OBJECTIVE: To assess the utility of cryopreserved human skin allografts (HSA) in wound care and wound healing following Mohs surgery. METHODS: Sixteen patients were treated with HSA following MCE and followed postoperatively for evidence of infection, involution, or survival of HSA, and granulation tissue production. Follow-up was 2-26 months. RESULTS: The use of HSA resulted in one of three general outcomes: rapid healing and rejection, subsequent full-thickness skin grafting, or persistence of HSA during prolonged healing. CONCLUSIONS:HSA are a safe alternative to immediate reconstruction in a carefully selected population of skin cancerpatients. They minimize wound care while providing continuous wound coverage during healing, and are an efficient bridge to full-thickness skin grafting.