Wilensky Jonathan S, Rosenthal Andrew H, Bradford Carol R, Rees Riley S
Department of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI 48109-0340, USA.
Ann Plast Surg. 2005 Mar;54(3):297-301.
Full-thickness defects of the scalp following cancer resection are reconstructive challenges when bone is exposed. Local, regional, and/or free tissue transfer have all been described for reconstruction when the pericranium is exposed. We examined the surgical outcomes from 23 patients who underwent placement of bovine collagen constructs. Thereafter, delayed skin grafting was performed. The average age of the patients was 70 years. All patients had one of the following: melanoma (n = 13) squamous cell carcinoma (n = 5), angiosarcoma (n = 2), basal cell carcinoma (n = 1), spindle cell carcinoma (n = 1), or malignant pilar tumor (n = 1). The average defect size was 51 cm, with a range of 9 cm to 169 cm. Average time between bovine construct placement and skin grafting was 30 days. Histologic studies demonstrated persistence of the construct and infiltration of nascent fibroblasts. Six patients had delayed healing due to microabscesses in the constructs. All wounds eventually healed. In the elderly, this is a simple method to treat full-thickness scalp defects.
癌症切除术后头皮出现全层缺损且骨外露时，重建颇具挑战性。当颅骨膜外露时，局部、区域和/或游离组织转移均已被描述用于重建。我们研究了23例行牛胶原蛋白构建物植入术患者的手术结果。此后，进行了延迟皮肤移植。患者的平均年龄为70岁。所有患者患有以下疾病之一：黑色素瘤（n = 13）、鳞状细胞癌（n = 5）、血管肉瘤（n = 2）、基底细胞癌（n = 1）、梭形细胞癌（n = 1）或恶性毛母细胞瘤（n = 1）。平均缺损大小为51平方厘米，范围为9平方厘米至169平方厘米。牛构建物植入与皮肤移植之间的平均时间为30天。组织学研究显示构建物持续存在且有新生成纤维细胞浸润。6例患者因构建物中出现微脓肿而愈合延迟。所有伤口最终均愈合。对于老年人而言，这是一种治疗头皮全层缺损的简单方法。
