Konofaos Petros, Kashyap Anil, Wallace Robert D
From the Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
J Craniofac Surg. 2014 Jul;25(4):1362-4. doi: 10.1097/SCS.0000000000000822.
The purpose of this case report is to present the reconstruction of a full-thickness scalp defect in a 2-year-old Hispanic male mauled by a dog, which was performed by a novel technique. After the scalp defect was debrided multiple times and treated with greater than 600 cm2 of cryopreserved human skin allograft, Integra was applied to the scalp defect following debridement and burring-out the outer bony cortex to promote bleeding and integration, followed by the application of a VAC dressing. Four weeks later, the mature Integra was grafted with split-thickness grafts. One year after the original injury, the patient demonstrated 98% take of the skin grafts to the calvarium. The resultant soft-tissue cover was supple, pliable, uniform in texture, and stable. The proposed technique of reconstruction of large full-thickness scalp defects in pediatric patients is easily reproducible, involves a short operative time, and produces satisfying cosmetic results.
本病例报告的目的是介绍一种新技术对一名被狗咬伤的2岁西班牙裔男性全层头皮缺损进行的修复。在对头皮缺损进行多次清创并使用超过600平方厘米的冷冻保存人皮肤异体移植物治疗后，清创并磨除外层骨皮质以促进出血和融合后，在头皮缺损处应用Integra，随后应用VAC敷料。四周后，将成熟的Integra移植中厚皮片。原始损伤一年后，患者头盖骨上的皮肤移植成活率达98%。最终的软组织覆盖柔软、柔韧、质地均匀且稳定。所提出的小儿患者大型全层头皮缺损重建技术易于重复操作，手术时间短，且美容效果令人满意。
