Introduction: Originally developed for acute burns, Integra provides effective reconstruction after melanoma excision in the scalp even over bone. Flap reconstruction after tumor resection in the elderly often requires general anesthesia and may increase tumor spread. Integra is preferred to flap reconstruction in these circumstances.

Methods: Twelve scalp wounds were reconstructed on 12 consecutive patients with Integra. Bolster dressings were applied for 5 days followed by saline dressing changes until skin grafting. Data collected included age, defect size, interval between Integra placement and skin grafting, graft take, and time until healed.

Results: Average age was 70.3 years (range 37-90). Defects averaged 54.4cm² (range 9-169cm²). 9 of 12 patients had exposed bone with no overlying pericranium. Mean time from Integra placement to STSG was 40 days. Mean graft take was 94%. All wounds were completely healed at 6 weeks. Two patients required repeat Integra placement but went on to heal.

Conclusions: Integra is a useful option in reconstruction of scalp defects. It is (1)technically simple and (2)may be used to cover areas of completely denuded bone. Integra may be preferable to scalp flap coverage since it (1)may produce less tumor spread and (2)does not require general anesthesia for placement.