• Cornelia Sigrid Lissi Müller, Claudia Schiekofer, Rebecca Körner, Claudia Pföhler, and Thomas Vogt.
• Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany. cornelia.mueller@uks.eu
• J Dtsch Dermatol Ges. 2013 Jun 1;11(6):537-48.

BackgroundThe incidence of skin tumors is increasing among elderly patients, and the multi-morbidities which occur in the elderly are a great challenge for dermatologic surgeons. The currently required safety margins for different types of melanomas and non-melanoma skin cancers lead to extensive and profound wounds.ObjectiveTo investigate the usefulness of a dermal substitute (Integra®) for routine use in surgery for dermatologic tumors.Patients And MethodsIn this retrospective study 20 patients underwent sequential surgeries for skin cancer. Wound closures were performed using Integra® (single layer) and immediate split-thickness skin graft.ResultsTwenty-two tumors (6 malignant melanomas, 10 squamous cell carcinomas, 2 pleomorphic sarcomas, 1 basal cell carcinoma, 2 Merkel cell carcinomas, and 1 trichoblastic carcinoma) were resected. The mean defect size was 41.4 cm(2) . All transplants were (65-100 %) vital; however, defects in the midface (cheek and infra-orbital area) often healed with esthetically disturbing, dense, pillow-like scars.ConclusionsWith the use of Integra®, the duration of hospitalization was decreased, patients with multi-morbidities were effectively treated, and functionally- and esthetically-satisfactory outcomes were achieved. On the basis of these observations, we discuss points of handling those patients who require rapid and effective surgery and undergo dermatologic surgery using dermal substitutes.© The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

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