Having read with interest the recent review by Pabst et al, we would like to add the acellular dermal matrix material “Integra™” to the exhaustive list they have extensively reviewed. We noted that they had excluded any case series of fewer than five patients.
A series by Murray et al described its use followed by an ultrathin skin graft for closing the donor site. Adams et al showed its use in treating a variety of wounds in the extremities.
We have used Integra™ to minimise the donor site scarring to treat a fit and healthy right-handed 37-year-old man who presented with a mucoepidermoid carcinoma arising from minor salivary glands in the hard palate. He required resection and reconstruction with a left radial forearm free flap. He had Type 1 Fitzpatrick skin, was prone to severe keloid scarring, and was not keen to have a skin graft that would cause further scars.
This material provides a dermal substrate consisting of denatured bovine collagen and shark chondroitin sulphate. It is available as either a monolayer construct or as a bilayer construct with a silastic outer portion. Two weeks after the arm dressing was removed, the Integra™ bilayer is shown in our patient ( Fig. 1 ).