Egemen Onur, Bingol Derya, Ozkaya Ozay, Aksan Tolga, Celik Suat Erol, Akan Mithat
Okmeydanı Research and Training Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey.
Turk Neurosurg. 2012;22(6):712-7. doi: 10.5137/1019-5149.JTN.6048-12.0.
Large defects of the scalp, head and neck region are often encountered by plastic surgeons. The repair of such defects is dependent upon their location, size and depth. This study describes the use of large scalp flaps as a salvage procedure in the reconstruction of large scalp, head and neck region defects in elderly patients with poor general condition or advanced malignancy.
The presented study includes 22 patients operated between 2007 and 2011 for the reconstruction of large defects of the hair-bearing skin and head/neck region with large scalp flaps. A defect exceeding 25 cm² area was classified as "large" as defined in the previous studies. The patients' medical records were analyzed.
Scalp flaps provided a satisfactory and durable reconstruction in the late follow-up term. All flaps were completely survived except in one case in which a partial necrosis in the distal margin occurred. Major complications were recorded in 4.5% of patients while minor complications were recorded in 13.5% of them.
In conclusion, large scalp flaps should be considered as a salvage procedure for reconstruction of large scalp, head and neck defects especially for palliative situations in elderly patients with significant comorbidities and advanced malignancies.
整形外科医生经常会遇到头皮、头颈部的大面积缺损。此类缺损的修复取决于其位置、大小和深度。本研究描述了在一般状况较差或患有晚期恶性肿瘤的老年患者中，使用大型头皮瓣作为挽救性手术来重建大面积头皮、头颈部缺损的情况。
本研究纳入了2007年至2011年间接受手术的22例患者，这些患者采用大型头皮瓣重建有毛发皮肤和头/颈部的大面积缺损。如先前研究中所定义，面积超过25平方厘米的缺损被归类为“大面积”。对患者的病历进行了分析。
在后期随访中，头皮瓣提供了令人满意且持久的重建效果。除1例远端边缘出现部分坏死外，所有皮瓣均完全存活。4.5%的患者出现了严重并发症，13.5%的患者出现了轻微并发症。
总之，大型头皮瓣应被视为重建大面积头皮、头颈部缺损的挽救性手术，特别是对于伴有严重合并症和晚期恶性肿瘤的老年患者的姑息治疗情况。
