Shimada Ken-ichi, Ishikura Naotaka, Heshiki Takaya, Kawakami Shigehiko
Department of Plastic and Reconstructive Surgery, Kanazawa Medical University, Ishikawa, Japan.
J Craniofac Surg. 2007 Nov;18(6):1305-8. doi: 10.1097/scs.0b013e31811ec238.
Although artificial dura maters such as Gore-Tex are used in cranioplasty, the use of artificial products occasionally results in the formation of infectious lesions. Recently, we encountered two patients who underwent brain surgery and contracted infection from artificial dura maters used for cranioplasty. To treat the postoperative infection, we prepared a vascularized fascia lata attached anterolateral thigh flap that could be applied to the infected wounds in the reconstruction of dura maters and obtained satisfactory results. The present study demonstrated that fascia lata attached anterolateral thigh flaps were useful for reconstructing intractable cranial fistulae complicated by infection. The disadvantages of our surgical technique were the impossibility of simultaneous bone reconstruction and the difficulty in creating a watertight closure of fascia and dura mater, although leakage of cerebrospinal fluid was not observed so far.
尽管在颅骨成形术中会使用如戈尔特斯(Gore-Tex)等人工硬脑膜,但使用人工制品偶尔会导致感染性病变的形成。最近,我们遇到了两名接受脑部手术并因颅骨成形术中使用的人工硬脑膜而感染的患者。为了治疗术后感染,我们制备了带血管蒂的阔筋膜张肌前外侧大腿皮瓣,可将其应用于感染伤口以重建硬脑膜,并取得了满意的效果。本研究表明,阔筋膜张肌前外侧大腿皮瓣对于重建并发感染的难治性颅骨瘘是有用的。我们手术技术的缺点是无法同时进行骨重建,以及难以实现筋膜和硬脑膜的水密性闭合,尽管目前尚未观察到脑脊液漏。