Reconstruction of Nasal Defects With Dermal Skin Substitutes-A Retrospective Study of 36 Defects

J Cutan Med Surg. 2019 Jul/Aug;23(4):413-420. doi: 10.1177/1203475419852060. Epub 2019 Jun 10.

Abstract

Objectives: It is uncertain whether dermal regeneration templates (DRTs) are helpful to reconstruct nasal defects. The aim of this study was to assess whether the aesthetic subunits determine the outcome.

Methods: In this unicentric, retrospective study, the surgical procedures and outcomes of patients who received DRTs to reconstruct nasal defects were assessed and compared with the involved aesthetic subunits.

Results: DRTs were used for reconstruction of 36 nasal defects in 35 patients with involvement of 76 aesthetic subunits: nasal sidewall (n = 21), nasal ala (n = 13), nasal tip/columella (n = 12, n = 1, respectively), nasal dorsum (n = 12), and extranasal aesthetic areas (n = 17). Fifty-eight nasal and 8 extranasal aesthetic subunits were reconstructed with DRTs, 10 subunits with a flap. Twenty-nine of 36 defects healed without any complications (80.5%). All reconstructed nasal tips/columella and the nasal dorsa healed without any complications. Region-specific complications were retraction of the ala rim (4/12; 33.3% of the patients with involvement of the nasal ala) and the formation of a fistula in the nasal sidewall (1/21; 4.8%). Region-specific complications of extranasal subunits were the development of an ectropium (2/3; 66.7% of the patients with involvement of the lower lid).

Conclusions: DRTs can be helpful to reconstruct nasal defects. However, if the defect involves the aesthetic subunits nasal ala or the infraorbital region, different techniques should be preferred.

Keywords: Integra; Matriderm; artificial skin; nasal defect; skin substitute.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chondroitin Sulfates / therapeutic use
  • Collagen / therapeutic use
  • Elastin / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose Deformities, Acquired / surgery*
  • Nose Neoplasms / surgery*
  • Retrospective Studies
  • Rhinoplasty / methods*
  • Skin Neoplasms / surgery*
  • Skin Transplantation
  • Skin, Artificial*
  • Surgical Flaps
  • Surgical Wound / surgery*
  • Treatment Outcome

Substances

  • integra artificial skin
  • matriderm
  • Chondroitin Sulfates
  • Collagen
  • Elastin