Nangole F W, Khainga S O
Department of Surgery, University of Nairobi, P.O. Box 30197, Nairobi, Kenya.
Case Rep Surg. 2017;2017:4821329. doi: 10.1155/2017/4821329. Epub 2017 Jan 17.
Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity.
广泛头皮缺损伴骨质外露最好采用皮瓣修复。目前，许多中心对大多数此类伤口常规采用游离皮瓣修复。然而，游离皮瓣手术时间长，并非所有患者都适用，因此在可能的情况下应鼓励采用创伤较小的修复方法。一名68岁患者因头皮顶部发生马乔林溃疡前来就诊。广泛局部切除术后，遗留了一个约17厘米×12厘米的缺损。采用同侧带蒂颞肌筋膜瓣和轴型眶上头皮瓣联合修复，成功覆盖了缺损，效果良好。总之，头皮广泛缺损可通过局部皮瓣联合修复完全覆盖。轴型头皮瓣和带蒂颞肌筋膜瓣在适用时为覆盖此类伤口提供了一种简便且要求较低的选择。这些皮瓣血供良好、可靠，供区并发症少。
