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Spray Skin Regenerative Therapy in Combination with a Dermal Regenerate Matrix for Restoration of Full-Thickness Cutaneous Oncologic Defects of the Face
Elie P. Ramly, MD; Jenna Daddario, PA-C; Ian Valerio, MD, MS, MBA, FACS
Harvard Plastic Surgery, Massachusetts General Hospital
(Mass General Brigham Program)
2024-01-15
Presenter: Elie Ramly, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting
Director Name: Ian Valerio (PI for this abstract); Kyle Eberlin (program PD)
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background
Facial full-thickness cutaneous defects present unique reconstructive challenges including concerns for increased scar burden, color mismatch, contour irregularity, and/or donor site morbidity. This pilot study reports on application of spray skin technology and dermal regenerate matrices (DRMs) for the restoration of facial oncologic defects.
Methods
Patient 1 is a 22-year-old female with a 7x6cm wide local excision (WLE) forehead defect after resection of a dermatofibrosarcoma protuberans. After negative margin confirmation, a DRM was applied over the exposed calvarium. After integration, a 0.007-inch 2.5x1cm posterior auricular split-thickness skin graft (STSG) was obtained and processed, yielding 2.5mL of spray skin. Patient 2 is a 30-year-old female who underwent WLE of a nasal dorsum melanoma resulting in a 2.5x2.5cm defect with exposed cartilage. After coverage and integration of a DRM, a 0.007-inch posterior auricular STSG (2x0.5cm) was processed into 2mL of spray skin. In both patient cases, the spray skin solution was applied to both the recipient and donor sites.
Results
Patient 1's and Patient 2's oncologic treatment areas were completely healed at 3.5 months and 3 weeks, respectively. Their STSG donor sites treated with spray skin healed completely within 10 days with acceptable aesthetic results. Both patients resumed normal activities, showering, and makeup application without complications.
Conclusions
The combined application of DRMs and non-cultured spray skin technology can effectively achieve re-epithelialization of full-thickness cutaneous facial oncologic wounds. This novel reconstructive approach to cutaneous defects of varying sizes and thickness can optimize aesthetics while minimizing scar burden and donor site morbidity.
