de Haas Louise E M, Gardien Kim L M, van Trier Antoine J M, Vloemans Adrianus F P M, Buis Dennis R
Burn Center, Red Cross Hospital.
Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk.
J Craniofac Surg. 2019 May/Jun;30(3):888-890. doi: 10.1097/SCS.0000000000005375.
Extensive full-thickness burn injury of the scalp involving the skull is a challenge to reconstruct. Here, the authors report a case of a 6-year old girl who suffered extensive flame burn injury involving a scalp defect of 1,5% total body surface area. After necrosectomy, full table damage of the skull was observed with a partially exposed dura mater. Neurosurgical consultation was necessary to accomplish a vital wound bed. Subsequently, in the absence of enough adequate tissue available for flap surgery reconstruction, reconstruction was performed by using a bilayer Integra Dermal Regeneration Template (IDRT) resulting in a lasting and stable coverage of the defect. This is the first case-report describing application of IDRT on a full-thickness scalp and skull defect with exposed dura mater in a child. Our results are encouraging and demonstrate that Integra can be used in a child to successfully cover exposed dura when no viable skull remains.
累及颅骨的头皮全层广泛烧伤损伤的重建是一项挑战。在此，作者报告了一例6岁女孩，她遭受了广泛的火焰烧伤，头皮缺损占体表面积的1.5%。在进行坏死组织切除术后，观察到颅骨全层损伤，硬脑膜部分暴露。需要神经外科会诊以建立一个至关重要的创面床。随后，由于没有足够的合适组织用于皮瓣手术重建，遂使用双层Integra真皮再生模板（IDRT）进行重建，从而实现了对缺损的持久稳定覆盖。这是首例描述IDRT应用于儿童全层头皮和颅骨缺损且硬脑膜暴露的病例报告。我们的结果令人鼓舞，表明当没有存活的颅骨时，Integra可用于儿童以成功覆盖暴露的硬脑膜。
