Use of Integra in Complex Pediatric Wounds

The usefulness of Integra is well described in the adult reconstructive and burn literature. There is limited documentation of its utility in the pediatric plastic surgery population. We presented 8 cases referred to us for flap coverage that were treated using Integra. These cases describe difficult wounds resulting from trauma, and congenital abnormalities. The charts of all 8 cases were retrospectively reviewed. There were 5 females and 3 newborns. The average age at coverage with Integra was 4.6 years (range, 1 day-16 years). There were 4 traumatic wounds, 2 cases of cutis aplasia, 1 myelomeningocele, and 1 case of congenitally absent cranium. The average time to coverage was 8 days, and all trauma patients underwent at least 2 prior washout procedures. The average area covered was 43 cm(2) (range, 6-100 cm(2)). At a mean follow-up of 14.25 months (range, 9-20 months), 7 patients' wounds had healed without need for further flap coverage. Only 1 patient required a skin graft over the Integra bed. There was 1 infection resulting in total dermal matrix loss and need for local flap reconstruction. One patient developed severe hypertrophic scarring requiring surgical revision. Integra is a reliable option in pediatric reconstruction, which may save a child the morbidity of a more extensive procedure.