Meissner M, Kaufmann R
Klinik für Dermatologie, Venerologie und Allergologie, Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
Hautarzt. 2011 May;62(5):354-61. doi: 10.1007/s00105-010-2089-2.
The reconstruction of scalp defects following tumor excisions can be a difficult surgical challenge. The size, location and the depth of the defect, but also the presence or absence of hair, the location of the hairline, the condition of the adjacent tissue and possible co-morbidities must be taken into account in order to choose an appropriate reconstructive technique. Even smaller defects often require local flaps and skin grafts. The increasing number of scalp tumors arising on the basis of actinic field cancerization often lead to large defects with exposed scalp bone. In this context flaps combined with split-thickness skin grafting of the donor site defect, granulation-inducing methods with second intention healing and the application of dermis equivalents are possible options to cover the exposed cranium. Adequate functional as well as aesthetic reconstruction of scalp defects require excellent understanding of the options and limits of the diverse closure techniques, good knowledge of the anatomy and proper preoperative planning.
肿瘤切除术后头皮缺损的重建可能是一项具有挑战性的外科手术。为了选择合适的重建技术，必须考虑缺损的大小、位置和深度，以及有无毛发、发际线位置、相邻组织状况和可能存在的合并症。即使是较小的缺损通常也需要局部皮瓣和植皮。基于光化性野癌化产生的头皮肿瘤数量不断增加，常常导致大面积缺损，头皮骨外露。在这种情况下，皮瓣联合供区缺损的断层皮片移植、二期愈合的肉芽诱导方法以及真皮替代物的应用都是覆盖外露颅骨的可行选择。头皮缺损的充分功能和美学重建需要对各种闭合技术的选择和局限性有深入了解，熟悉解剖结构并进行适当的术前规划。
