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Case Reports in Otolaryngology
Volume 2013, Article ID 917183, 5 pages
http://dx.doi.org/10.1155/2013/917183
Case Report

Salvage of Failed Local and Regional Flaps with Porcine Urinary Bladder Extracellular Matrix Aided Tissue Regeneration

1Department of Otolaryngology, Head and Neck Surgery, Wayne State University School of Medicine, 4201 St. Antoine, 5E-UHC, Detroit, MI 48201, USA
2Department of Otolaryngology, Head and Neck Surgery, Wayne State University School of Medicine and Karmanos Cancer Institute, 4201 St. Antoine, 5E-UHC, Detroit, MI 48201, USA
3Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, Wayne State University School of Medicine and Karmanos Cancer Institute, 4201 St. Antoine, 5E-UHC, Detroit, MI 48201, USA

Received 30 July 2013; Accepted 4 September 2013

Academic Editors: M. T. Kalcioglu, Y. Orita, A. Rapoport, and M. S. Timms

Copyright © 2013 Gregory J. Kruper et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Local and regional flap failure can be a major complication in head and neck surgery, which continue to be prevalent for a number of reasons including poor flap design, improper surgical technique, and poor tissue vascularity. Dealing with these failures can be quite difficult. Surgical debridement, flap revisions, and complex wound regimens are necessitated to reestablish appropriate tissue coverage. Traditional use of wet to dry dressing to enable proper wound granulation and possible closure with additional flaps or skin grafts is a laborious process. Such treatments place great time burdens on the patient, physicians, and nurses. Because the face and neck possess a complex three-dimensional topography, wound dressings are inherently complex to design and change. Many patients also require postoperative treatments such as radiation and chemotherapy to treat aggressive malignancies, and delay in wound healing leads to a delay in adjuvant treatment. Recently, advances in regenerative medicine, specifically xenogeneic extracellular matrix compounds, have been shown to promote tissue growth while limiting scar tissue formation (Badylak 2004). To our knowledge, this paper is the first case series using the porcine extracellular matrix bioscaffold (MatriStem ACell, Columbia, MD, USA) to salvage flaps with extensive wound breakdown on the face and neck.