Department of Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Microsurgery. 2019 Mar;39(3):207-214. doi: 10.1002/micr.30345. Epub 2018 Jul 3.
Complex defects resulting in ablation of the scalp, the calvaria, the dura, and the underlying brain are still challenging. These defects require cranioplasty to restore the bone cosmetic and functional roles and free-flap soft tissue reconstruction to prevent cranioplasty exposure and further infection. Different materials have been used in cranioplasty, while different free flaps have been proposed in those cases. In this article, we present a case series of cranioplasty reconstruction with thoracodorsal artery perforator flap (TDAP).
From April 2016 to January 2018, 5 patients underwent cranioplasty reconstruction using alloplastics and TDAP flap. Two patients underwent primary cranioplasty and 3 patients underwent secondary cranioplasty. The superficial temporal vessels were always dissected as recipient vessels.
The flap sizes range from 40 to 80 cm (mean 57 cm ) and the maximum pedicle length was 12 cm (mean 10 cm). All the donor sites were closed primary with minimal morbidity. No postoperative complications were experienced. All the flaps provided stable coverage with an acceptable color match. The mean follow-up time was 4 months.
Our data suggest that the TDAP may be employed in postcranioplasty reconstruction. The TDAP has more advantages compared to other flaps used in alloplastic reconstruction: a broad large surface, a long pedicle, and a thinner thickness.
头皮、颅骨、硬脑膜和脑实质复杂缺损的修复仍然具有挑战性。这些缺损需要颅骨修复术来恢复颅骨的美容和功能作用，以及游离皮瓣软组织重建以防止颅骨修复术暴露和进一步感染。颅骨修复术中使用了不同的材料，而在这些情况下也提出了不同的游离皮瓣。在本文中，我们报告了一组使用胸背动脉穿支皮瓣（TDAP）进行颅骨修复重建的病例系列。
从 2016 年 4 月至 2018 年 1 月，5 名患者接受了使用同种异体材料和 TDAP 皮瓣的颅骨修复重建。2 名患者行原发性颅骨修复术，3 名患者行继发性颅骨修复术。始终将颞浅血管解剖作为受区血管。
皮瓣大小范围为 40 至 80cm（平均 57cm），最大蒂长为 12cm（平均 10cm）。所有供区均一期直接闭合，并发症发生率低。无术后并发症。所有皮瓣均提供稳定的覆盖，颜色匹配可接受。平均随访时间为 4 个月。
我们的数据表明，TDAP 可用于颅骨修复术后的重建。与其他用于同种异体重建的皮瓣相比，TDAP 具有更多的优势：皮瓣面积大、蒂长、厚度薄。
