Steiner D, Hubertus A, Arkudas A, Taeger C D, Ludolph I, Boos A M, Schmitz M, Horch R E, Beier J P
Department of Plastic and Hand Surgery (Head: Univ. Prof. Dr. med. Dr. h.c. R. E. Horch), University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Plastic and Hand Surgery (Head: Univ. Prof. Dr. med. Dr. h.c. R. E. Horch), University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany.
J Craniomaxillofac Surg. 2017 Feb;45(2):319-324. doi: 10.1016/j.jcms.2016.11.023. Epub 2016 Dec 7.
Scalp reconstruction is a challenging task for the reconstructive surgeon. In consideration of the anatomical and cosmetic characteristics, the defect depth and size, an armamentarium of reconstructive procedures ranging from skin grafts over local flaps to free tissue transfer has been described. In this 10-year retrospective study, 85 operative procedures for scalp reconstruction were performed at our department. The underlying entity, defect size/depth, reconstructive procedure, complications, and mean hospital stay were analyzed. In most cases, scalp reconstruction was necessary after oncologic resection (67%) or radiation therapy (16%). A total of 85 operative procedures were performed for scalp reconstruction including local flaps (n = 50), free tissue transfer (n = 18), and skin grafts (n = 17). Regarding the complication rate, we could detect an overall major complication rate of 16.5% with one free flap loss. Briefly, local flaps are an adequate and safe procedure for limited scalp defects. In the case of extensive scalp defects affecting the calvarium, prior multiple surgical interventions and/or radiation, we prefer free tissue transfer.
头皮重建对重建外科医生来说是一项具有挑战性的任务。考虑到解剖学和美学特征、缺损深度和大小，已经描述了一系列从皮肤移植、局部皮瓣到游离组织移植的重建手术方法。在这项为期10年的回顾性研究中，我们科室共进行了85例头皮重建手术。对潜在病因、缺损大小/深度、重建手术、并发症及平均住院时间进行了分析。在大多数情况下，头皮重建是在肿瘤切除术后（67%）或放射治疗后（16%）进行的。共进行了85例头皮重建手术，包括局部皮瓣（n = 50）、游离组织移植（n = 18）和皮肤移植（n = 17）。关于并发症发生率，我们发现总体主要并发症发生率为16.5%，有一例游离皮瓣丢失。简而言之，局部皮瓣对于有限的头皮缺损是一种合适且安全的手术方法。对于影响颅骨的广泛头皮缺损、先前多次手术干预和/或放疗的情况，我们更倾向于游离组织移植。
