What biologic skin substitute would be best for post Mohs procedure for large facial squamous cell?

Integra is the most suitable biologic skin substitute for a post Mohs procedure involving large facial squamous cell carcinoma for several reasons. Firstly, Integra consists of a two-layer structure that provides both a dermal and epidermal component, making it an effective choice for reconstructing complex wounds after extensive skin cancer surgery. The dermal layer is made of a collagen-chondroitin sulfate matrix, which promotes neovascularization and supports the infiltration of host cells, allowing for effective integration into the surrounding tissue.

Secondly, the fact that it is designed to allow for autologous skin grafting makes it a practical option for facial reconstruction, where preserving the aesthetic and functional aspects of the skin is crucial. After the dermal layer integrates with the wound bed, a thin skin graft can be placed over the membrane to facilitate further healing, leading to a favorable cosmetic outcome.

Other substitutes, while beneficial for different types of wounds, may not provide the same level of versatility and integration that Integra offers. AlloDerm is often utilized for soft tissue repair but may not be as effective for extensive coverage needs. Apligraf and Dermagraft are primarily used for chronic wounds and may not be as suitable for acute surgical wounds resulting from Mohs surgery