Liu Hongyuan, Li Zongping, Yang Liling, Yang Xu, Zhang Yan, Chen Jia
Department of Neurosurgery.
Department of Nephrology.
Medicine (Baltimore). 2019 Nov;98(48):e17830. doi: 10.1097/MD.0000000000017830.
Neonatal scalp mass is common in clinical practice. After birth canal compression and traction force, a cephalohematoma is usually found. However, cephalohematoma with abscess is extremely rare and dangerous. So far, there have been no reported cases of multidrug-resistant Escherichia coli infections in giant neonatal scalp hematoma.
We present a 9-day-old with a scalp abscess and a large scalp defect that remained after surgical drainage.
Physical examination showed a giant mass suggestive in the parietal region. B-mode ultrasound indicated the scalp mass was liquid. The early diagnosis was massive scalp hematoma. During conservative treatment, purulent fluid flowed from the mass region through a rupture in the scalp. MR examination showed the scalp had burst and no abnormalities were found in the medial side of the skull and skull.
The surgeon opened up the mass and removed necrotic tissue. The scalp was severely damaged; the aseptic auxiliary materials that we made in-house were used to gradually reduce the defect.
The scalp was healed by anti-infection treatment and frequent changing of the dressings. The patient was successfully treated without two-stage surgery. There were no complications.
A scalp hematoma is a potential site of infection. Anti-infection treatment and surgery are necessary to correct infected scalp hematoma. This work offers a new way of treating other large scalp defects.
新生儿头皮肿物在临床实践中较为常见。经产道挤压和牵引力作用后，通常会发现头皮血肿。然而，伴有脓肿的头皮血肿极为罕见且危险。迄今为止，尚未有巨大新生儿头皮血肿合并多重耐药大肠杆菌感染的病例报道。
我们报告一例9日龄患儿，患有头皮脓肿以及手术引流后遗留的巨大头皮缺损。
体格检查显示顶叶区域有一巨大肿物。B超显示头皮肿物为液性。早期诊断为巨大头皮血肿。在保守治疗期间，脓性液体从肿物区域经头皮破裂处流出。磁共振检查显示头皮已破溃，颅骨内侧及颅骨未见异常。
外科医生切开肿物并清除坏死组织。头皮严重受损；我们自制的无菌辅助材料用于逐渐缩小缺损。
通过抗感染治疗和频繁换药，头皮愈合。患儿未经二期手术即成功治愈，无并发症发生。
头皮血肿是潜在的感染部位。对于感染性头皮血肿，抗感染治疗和手术是必要的。这项工作为治疗其他巨大头皮缺损提供了一种新方法。
