Mahmoud Wael H
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
World J Plast Surg. 2021 Jan;10(1):30-36. doi: 10.29252/wjps.10.1.30.
We aimed to review the treatment and outcome of patients' undergone reconstruction of large full thickness scalp defects with exposed calvarium after oncologic resection with the combined local flap and split-thickness skin graft (STSG) technique.
A retrospective review of 45 patients with scalp defects secondary to tumor extirpation was performed at the Plastic Surgery Department, Tanta University Hospital, Tanta, Egypt from Nov 2016 to Nov 2019. Patients, with large (>50 cm2) and full-thickness (exposed calvarium) scalp defects, who underwent scalp reconstruction with the combined local flap and STSG technique and had completed their medical records were enrolled.
Only 38 met the inclusion criteria. Thirty-three were male (86.8). The mean age was 61.5 years. The lesions removed were BCC in 30 cases (78.9%) and SCC in 8 cases (21.1%). Defect sizes ranged from 55 to 196 cm2. There was complete survival of all flaps. Complications were noticed in 5 patients (13.2%);2 developed small hematomas, 2 suffered from partial graft losses and one had wound infection. The follow-up period ranged from 6 to 27 months. Overall, 34 patients were satisfied with the functional and cosmetic results (89.5%), while 4 female patients weren't satisfied with the esthetic results (10.5%).
The combination of local flap and skin graft technique is highly reliable, easy to perform and safe single-stage reconstructive modality of large skull exposed scalp defects, providing durable coverage and favorable esthetic outcome.
我们旨在回顾采用局部皮瓣联合中厚皮片移植（STSG）技术对肿瘤切除术后出现颅骨外露的大面积全层头皮缺损患者进行治疗的情况及结果。
2016年11月至2019年11月在埃及坦塔坦塔大学医院整形外科对45例因肿瘤切除导致头皮缺损的患者进行了回顾性研究。纳入了那些存在大面积（>50 cm²）全层（颅骨外露）头皮缺损、采用局部皮瓣联合STSG技术进行头皮重建且病历完整的患者。
只有38例符合纳入标准。33例为男性（86.8%）。平均年龄为61.5岁。切除的病变中，基底细胞癌（BCC）30例（78.9%），鳞状细胞癌（SCC）8例（21.1%）。缺损面积从55至196 cm²不等。所有皮瓣均完全存活。5例患者（13.2%）出现并发症；2例出现小血肿，2例部分植皮失败，1例发生伤口感染。随访时间为6至27个月。总体而言，34例患者对功能和美容效果满意（89.5%），而4例女性患者对美容效果不满意（10.5%）。
局部皮瓣和植皮技术相结合是一种高度可靠、易于实施且安全的单阶段重建方式，可用于修复大面积颅骨外露的头皮缺损，能提供持久的覆盖并获得良好的美容效果。
