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STRAVIX◊ Tissue Products in surgical reconstruction of the scalp: two case studies
Resection of a scalp cancer often leaves a large defect that can be challenging to close due to the inelasticity of surrounding tissue, the depth of excavation, and existing comorbidities which are more often present in elderly patients who suffer more scalp cancers than the general population.1 Because tumor removal often results in such complex wounds that involve challenging scalp reconstructions, tissue grafts that offer predictable results with demonstrated efficacy are increasingly in demand—like STRAVIX Tissue Products.
A growing number of thought leading surgeons have made STRAVIX Tissue a preferred skin substitute, such as Harishanker Jeyarajan, M.D., associate professor and Head and Neck Plastic Surgeon and Surgical Oncologist at the University of Alabama at Birmingham. Dr. Jeyarajan brings us two surgical case studies involving carcinoma of the scalp where he successfully used STRAVIX Tissue Products.
STRAVIX Cryopreserved Umbilical Tissue following removal of basal cell carcinoma
Diagnosis
Dr. Jayarajan’s first case features a 60-year-old male with a previous medical history of type II diabetes. The patient presented with a diagnosis of basal cell carcinoma to the scalp which had been treated six days prior with MOHs surgery.
Procedure
Dr. Jayarajan took the patient to the OR on day 10; the wound measured 16 cm x 5 cm x 0.5 cm. The wound was debrided and STRAVIX Tissue sutured in place. The wound was covered with CUTICERIN Low-adherent Surgical Dressing and negative pressure wound therapy (NPWT) applied continuously at 125mmHG for the first two weeks.
One month after the STRAVIX Tissue application to build granulation tissue, the patient returned to the OR for an application of a split thickness skin graft (STSG). After the STSG, negative pressure wound therapy was applied for another week.
Outcome
For patients with comorbidities such as diabetes, surgery often leads to longer length of stay, more post-surgical complications, higher readmission rates and increased costs.2,3
Yet in this case, the patient required no hospitalization—both procedures and follow-up visits were done as an outpatient with local wound care, saving thousands in hospitalization costs and allowing the patient to recover and heal at home. Both Dr. Jayarajan and the patient were pleased with the results and relieved a free flap reconstruction or rotational scalp flap were avoided.
Composed of native human umbilical tissue components, STRAVIX Tissue Products intimately conform to bony areas and are available in sizes suitable to large flat areas. And because they are strong and easily sutured, they can be used as a cover or wrap in various surgical procedures, including, but not limited to challenging scalp reconstruction like the one discussed here.
STRAVIX Meshed Tissue and the deep excision of Melanoma
In his second case, Dr Jayarajan used STRAVIX Meshed Tissue for the scalp reconstruction of an 82-year-old man following excision of a Melanoma. The patient had a complex history including A fib, hypertension, hypothyroidism, multiple skin cancers, and renal cancer.
Procedure
At the vertex of the scalp, Dr. Jayarajan resected down to the bone of the skull resulting in a wide local lesion excision leaving a wound measuring 8 cm x 8 cm x 0.75 cm. STRAVIX Meshed Tissue was sutured into place and covered with ADAPTIC Nonadherent Dressing. Negative pressure wound therapy was applied over the graft and was removed at day 13. Sentinel lymph node biopsy was also performed.
Following NPWT, a dressing of CUTICERIN Low-Adherent Surgical Dressing and Telfa gauze were changed daily. At the first post op visit at day 13, granulation was present. At the second post op visit at day 25, the wound showed continued improvement. The patient was taken back to the O.R. on day 36 when a split thickness skin graft was performed.
Outcome
Following surgical treatment, the patient completed adjuvant radiation treatment to the scalp and did not experience any wound breakdown or tissue compromise. His wound showed complete closure in 3.5 months (109 days). And like Dr. Jayarajan’s first case, the patient required only 2 outpatient surgeries and 4 post-op clinic visits, a significant cost savings and again, the patient was allowed to recover at home.
Why STRAVIX Tissue Products?
The choices are plentiful, but STRAVIX Tissue Products are manufactured using proprietary processes allowing the structural tissues to retain all native components including growth factors, a hyaluronic-acid rich extracellular matrix, and intact placental cells.3,4 In fact, A single STRAVIX Tissue can provide fast closure for soft tissue defects and complex wounds.5 For larger wounds you can choose STRAVIX Meshed Tissue which is easily stretched to cover larger area and provides a more affordable choice.
In addition, STRAVIX PL Lyopreseved Umbilical Tissue retains all the native components of the tissue while requiring no thawing or special refrigeration for off-the-shelf, on-demand convenience.
Learn more here: https://webinars.hmp1.com/how-incorporate-innovative-cellular-andor-tissue-products-your-treatment-plan
*Disclaimer
References
- Sinikumpu, SP., Jokelainen, J., Keinänen-Kiukaanniemi, S. et al. Skin cancers and their risk factors in older persons: a population-based study. BMC Geriatr 22, 269 (2022). https://doi.org/10.1186/s12877-022-02964-1
- Healy MA, Mullard AJ, Campbell DA Jr, Dimick JB. Hospital and Payer Costs Associated With Surgical Complications. JAMA Surg. 2016;151(9):823-830. doi:10.1001/jamasurg.2016.0773
- Korol E, Johnston K, Waser N, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013; 8(12): e83743.
- Dhall S, Coksaygan T, Hoffman T, et al. Viable cryopreserved umbilical tissue (vCUT) reduces post-operative adhesions in a rabbit abdominal adhesion model. Bioact Mater. 2018; 4(1): 97-106.
- Data on file.
- McGinness K, Kurtz Phelan DH. Use of viable cryopreserved umbilical tissue for soft tissue defects in patients with gas gangrene: A case series. Wounds. 2018; 30(4): 90-95.
For detailed product information, including indications for use, contraindications, precautions and warnings, please consult the product’s applicable Instructions for Use (IFU) prior to use.
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