# Integra Dermal Regeneration Template in Reconstruction of Primary Oncologic Defects in the Lower Extremities: A Case Series

## TL;DR

This case series shows how a dermal regeneration template helps reconstruct complex leg defects after tumor removal, allowing for easier later revisions.

## Contribution

The study demonstrates the novel use of IDRT in oncologic lower extremity reconstruction with uncertain tissue margins.

## Key findings

- IDRT successfully facilitated neodermis growth to support skin grafting in all four cases.
- Use of IDRT allowed surgical revision of positive margins without losing graft tissue in a single procedure.
- Negative pressure wound therapy improved neodermis quality for skin graft acceptance.

## Abstract

This article presents a case series of 4 patients who underwent primary reconstruction of oncologic defects in the lower extremities using Integra Dermal Regeneration Template (IDRT). The patients had either primary or recurrent tumors, which resulted in exposure of deep underlying structures including tendon, nerve, muscle, and bone. IDRT was selected to manage these defects due to the uncertain malignant potential of tissue margins and its ability to facilitate later margin revision without sacrificing tissue. The use of IDRT allowed for the growth of a neodermis that supported subsequent split-thickness skin grafting in all cases. Additionally, for those with positive margins, surgical revision and skin graft application was able to be performed in a single procedure, maximizing operating room use and patient convenience. This case series highlights the potential of IDRT in managing complex oncologic defects in the lower extremities, expanding options for reconstructive surgeons. Key findings: (1) IDRT is a viable option for reconstruction in oncologic resections exposing deep structures. (2) In cases with unknown malignant potential of tissue margins, use of IDRT can allow for revision of positive margins without sacrificing graft or flap tissue. (3) Negative pressure wound therapy is an important adjunct in achieving a favorable neodermis for acceptance of a spilt thickness skin graft.