Boeckx Willy D, van der Hulst René R W J, Nanhekhan Lloyd V, De Lorenzi Francesca
Department of Plastic Surgery, Hand Surgery and Microsurgery, University Hospital of Maastricht, Maastricht, The Netherlands.
Neurosurgery. 2006 Jul;59(1 Suppl 1):ONS64-7; discussion ONS64-7. doi: 10.1227/01.NEU.0000219894.58901.46.
To evaluate the efficacy of the combination of an extensive surgical debridement and simultaneous free flap repair in case of troublesome cranial osteomyelitis.
Five patients with persistent, frontal bone osteomyelitis were treated with surgical debridement of the infected bone and reconstruction with a free flap. In all patients, osteomyelitis occurred after neurosurgical procedures and lasted from 1 to 7 years. A latissimus dorsi muscle flap with a split skin graft has been performed.
No flap failure occurred and donor site morbidity was negligible. No signs of osteomyelitis or soft tissue infection were observed during the mean follow-up period of 3.2 years. Furthermore, the contour of the cranium could be preserved without a need for bone grafts or implants.
In our experience, the combination of an extensive surgical debridement and a free flap transfer is demonstrated to be an effective treatment for "chronic" osteomyelitis of the cranium.
评估广泛手术清创联合同期游离皮瓣修复治疗难治性颅骨骨髓炎的疗效。
对5例持续性额骨骨髓炎患者进行感染骨的手术清创，并用游离皮瓣进行重建。所有患者的骨髓炎均发生于神经外科手术后，病程持续1至7年。均采用背阔肌肌皮瓣加断层皮片移植。
未发生皮瓣坏死，供区并发症可忽略不计。在平均3.2年的随访期内，未观察到骨髓炎或软组织感染迹象。此外，无需植骨或植入物即可保留颅骨外形。
根据我们的经验，广泛手术清创联合游离皮瓣转移是治疗颅骨“慢性”骨髓炎的有效方法。
