Gironi Laura C, Boggio Paolo, Colombo Enrico
Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy.
Dermatol Ther. 2015 May-Jun;28(3):114-7. doi: 10.1111/dth.12193. Epub 2014 Dec 29.
Treatment of scalp defects after tumor resection or traumatic events is a challenging problem. Large defects with loss of soft tissue down to the bone require complex reconstructive options, including tissue expansion, local and distal scalp flaps, and free split thickness skin graft. Nonetheless, these techniques are often disfiguring and are limited by the relatively poor elasticity and vascularity of scalp tissues after recurrent resection or previous irradiation. Moreover, comorbid conditions among elderly patients often limit anesthetic tolerance and the use of distant flaps. We report a case of a 75-year-old woman with large tissue loss and bone exposure after Mohs micrographic surgery of basal cell carcinoma of the scalp which was successfully rebuilt through the use of a skin substitute. We describe the uncommon use of a bilayer matrix wound dressing as a single procedure option for the management of full-thickness scalp defects with bone exposure.
肿瘤切除或外伤后头皮缺损的治疗是一个具有挑战性的问题。伴有软组织直至骨质缺失的大面积缺损需要复杂的重建方案，包括组织扩张、局部和远位头皮瓣以及游离断层皮片移植。尽管如此，这些技术往往会造成毁容，并且受复发性切除或既往放疗后头皮组织相对较差的弹性和血运的限制。此外，老年患者的合并症常常限制麻醉耐受性和远位皮瓣的使用。我们报告了一例75岁女性患者，其头皮基底细胞癌经莫氏显微外科手术后出现大面积组织缺失和骨质外露，通过使用皮肤替代品成功重建。我们描述了双层基质伤口敷料作为处理伴有骨质外露的全层头皮缺损的单一手术选择的罕见应用。
