Dong Liwei, Dong Yulin, Liu Chaohua, Geng Jian, Liu Hengxin, Pei Jiaomiao, Hao Dongyue, Ma Xianjie, Xia Wensen
Department of Plastic Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
J Craniofac Surg. 2020 Mar/Apr;31(2):351-354. doi: 10.1097/SCS.0000000000006016.
Titanium mesh was widely used for cranium defect repair but associated with high complication rates. In this study, the authors describe a method using latissimus dorsi-myocutaneous flap in the repair of titanium mesh exposure and scalp defect after cranioplasty, and the plate retaining is also achieved. Fifteen patients from April 2012 to May 2016 underwent this procedure, the age ranged from 32 to 62 years and 47 years old on average, and all the patient had plate exposure combined with surgical site infection and variation of scalp defect. All the patients had fully flap survive, and follow up ranged from 6 months to 24 months, 1 patient had titanium mesh re-expose and received additional operation to remove the plate. The free latissimus dorsi musculocutaneous flap could supply large size of bulky tissue coverage with good blood supply and strong anti-infection ability. This method was an option for retaining the titanium mesh and repairing the exposure for the mild infection with small size scalp defect patient.
钛网曾广泛用于颅骨缺损修复,但并发症发生率较高。在本研究中,作者描述了一种使用背阔肌肌皮瓣修复颅骨成形术后钛网外露及头皮缺损的方法,同时实现了钛板保留。2012年4月至2016年5月,15例患者接受了该手术,年龄在32岁至62岁之间,平均47岁,所有患者均有钛板外露并伴有手术部位感染及头皮缺损变异。所有患者皮瓣均完全存活,随访时间为6个月至24个月,1例患者钛网再次外露并接受了额外手术取出钛板。游离背阔肌肌皮瓣可提供大面积、组织丰厚的覆盖,血供良好,抗感染能力强。该方法是保留钛网并修复轻度感染、小面积头皮缺损患者外露情况的一种选择。