Use of bilayer matrix wound dressing in the exenterated socket

ABSTRACT

To describe the novel use of a bilayer dermal substitute to reconstruct exenterated orbits. A retrospective chart review was performed in the practices of two surgeons (RET and PDL) of all patients who had undergone orbital exenteration between April 2014 and June 2016 and whose subsequent reconstruction included lining the socket with Integra bilayer. Patient demographics, pathologic diagnoses, surgical and post-operative complications, graft integrity, and patient acceptance were recorded. The charts of 7 patients (4 men and 3 women, ages 60–87 years) were reviewed. In all cases, the Integra graft had taken well to the socket bed at the time of silicone removal 3-4 weeks after surgery. Epithelialization of the socket occurred rapidly over the Integra graft (within several weeks) without incident in each case and with minimal postoperative management. No intraoperative or postoperative complications were noted. Integra dermal substitute is an ideal graft for the lining of an exenterated orbit. It is readily available in large quantities, handles easily, lines the socket smoothly, epithelializes rapidly, and requires minimal postoperative care. It offers minimal morbidity compared to skin grafting or free flap reconstruction, but greatly speeds epithelialization compared to laissez faire management. Surgeons should consider reconstructing exenterated orbits with the Integra matrix, both for its ease of use and its ability to epithelialize rapidly.

KEYWORDS:

• Exenteration
• reconstruction
• wound care
• artificial dermis

Acknowledgments

This material was previously presented as a poster for the American Academy of Ophthalmology 2015 Meeting and as a podium presentation for the 2015 American Society of Ophthalmic Plastic and Reconstructive Surgery 46^th Annual Fall Scientific Symposium; November 12th, 2015. Permission granted from the journals Ophthalmology and Ophthalmic Plastic and Reconstructive Surgery to submit to Orbit.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.