Section of Plastic Surgery, National Cheng-Kung University College of Medicine and Hospital, Tainan, Taiwan.
Microsurgery. 2010 Nov;30(8):632-5. doi: 10.1002/micr.20808. Epub 2010 Aug 23.
Recalcitrant epidural abscess following cranioplasty is a complicated problem, which becomes even more trying when large span of dura and skull bone are being replaced by alloplastic materials. A 22-year-old male underwent right fronto-temporo-parietal craniectomy and duroplasty with artificial dura graft after traumatic brain injury. Epidural abscesses recurred after cranioplasty with autologous bone graft as well as with a methyl methacrylate bone plate. The massive defects of both the dura and skull bone (15 × 9 cm) caused by radical debridement were reconstructed successfully with a combined free latissimus dorsi and serratus anterior myo-osseous flap transfer plus galea flap transposition. Proper contour and adequate stability of the construct were maintained during 2-year follow up without episodes of relapsing infection.
颅骨成形术后出现顽固的硬膜外脓肿是一个复杂的问题，当大量硬脑膜和颅骨被同种异体材料替代时，问题会变得更加棘手。一名 22 岁男性因颅脑外伤接受了右额颞顶颅骨切除术和硬脑膜修补术，使用人工硬脑膜移植物。颅骨成形术后，自体骨移植和甲基丙烯酸甲酯骨板均出现硬膜外脓肿复发。彻底清创后导致硬脑膜和颅骨（15×9cm）的巨大缺损，通过游离背阔肌和前锯肌肌骨瓣转移联合骨膜瓣转位成功重建。在 2 年的随访中，该结构的适当轮廓和足够的稳定性得以维持，没有复发感染的情况。
