Dermal Substitute Integra for the Treatment of Mammalian Bite Injuries of Nose: a New Reconstructive Ladder

Abstract

Background:. Bite injuries affecting the nose are uncommon occurrences characterized by their intricate nature and potential for severe complications. These injuries, inflicted by animals such as dogs and cats, and occasionally by humans, often result in traumatic nasal defects, with the lower third of the nose being the most affected area. Current reconstructive options for nasal defects include full-thickness skin grafts, local or regional flaps, and composite grafts. The traditional reconstructive ladder serves as a valuable guide for surgeons, outlining a continuum of treatment options from simpler to more complex interventions. Advancements in reconstructive technologies, such as the introduction of dermal substitutes, have reshaped the decision-making process, ushering in a new era of facial reconstruction. Methods:. In this context, dermal substitutes have emerged as promising adjuncts in nasal reconstruction, drawing from their success in burn surgery. Notably, the bilayered dermal substitute Integra has demonstrated efficacy in promoting wound healing and facilitating tissue regeneration. By harnessing the regenerative potential of Integra, plastic surgeons can address specific nasal defects arising from bite injuries with greater precision and improved outcomes. Results:. This study aims to present a case series of patients with bite injuries to the nose, showcasing the successful application of Integra dermal substitute in conjunction with secondary full-thickness skin grafting. Conclusions:. Through a retrospective analysis of patient demographics, injury characteristics, surgical interventions, and postoperative outcomes, we seek to underscore the utility of this combined approach in achieving optimal functional and aesthetic results. We aim to contribute to the evolving paradigm of nasal reconstruction.