A case of successful delayed reconstruction using a collagen based dermal substitute of a chemical burn injury to the face caused by sulphuric acid

Two-stage reconstruction of head and neck defects after tumor resection with a dermal regeneration template

BACKGROUND

Large defects after tumor resection in the head and neck area can be reconstructed with local flaps or skin grafts or heal by secondary intention. Especially in elderly patients, a rapid procedure with an acceptable aesthetic and reliable functional outcome is required.

OBJECTIVE

We investigated an alternative strategy using the Integra Dermal Regeneration Template (IDRT) for the reconstruction of large defects.

METHODS

In 18 patients (75 ± 3 years), 19 extended head and neck defects were treated with IDRT to enhance healing.

RESULTS

The mean defect size was 32 ± 7 cm2. The defects were transplanted within a mean postoperative time of 25 ± 2 days and overall showed good cosmetic results and stable scars. The mean follow-up time was 11 ± 1 months. Minor complications were hyperpigmentation (n  =  1), small ulcus (n  =  1), one minor ectropion (n  =  1), and partial loss of the skin graft after immediate radiotherapy (n  =  1). In one patient, the silicon layer had to be removed after 8 days owing to partial destruction of the IDRT. We observed shrinkage of 50 ± 4% within 6 months.

CONCLUSION

IDRT is an alternative technique for the reconstruction of extended head and neck defects. It can be conducted without major complications and with a short healing time and acceptable cosmetic results in elderly patients.

Chemical assault and skin/eye burns: two representative cases, report from the Acid Survivors Foundation, and literature review

Chemical assault is a significant problem throughout the world, resulting in disfigurement, sometime blindness or vision impairment, and constituting a major economic burden on otherwise overwhelmed health services in developing countries. Two representative cases are presented here. One involved domestic spouse abuse with an acid and the second involved a teen-aged female assaulted with an acid, perhaps for retribution over a local judicial matter. Such atrocities have a world-wide scope, which is reviewed here. Preventive measures are the most appropriate response. However, when such chemical assaults do occur, active measures to mitigate or negate their effects deserve consideration.