Malahias Marco, Ackling Edward, Zubair Omer, Harper Natasha, Al-Rawi Haytham, Khalil Haitham
Department of Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Department of Trauma & Orthopaedic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
J Neurol Surg B Skull Base. 2021 Feb 4;82(6):689-694. doi: 10.1055/s-0040-1715560. eCollection 2021 Dec.
Cutaneous malignancies are on the rise, associated with an increased number in scalp cancers that require wide local excision (WLE) to ensure clearance; the inelastic nature of the scalp poses a particular challenge when dealing with such large defects. A series of 68 cases with large scalp defects following WLE for the clearance of squamous cell carcinoma, atypical fibroxanthoma, dermatofibrosarcoma protuberans, and melanoma skin cancers are presented. These cases were treated in one center under local anesthesia and underwent extended scalp flaps to close the resulting defect primarily without the use of skin grafts for the flap donor site on the scalp. Extended scalp flap is a safe and reproducible solution for extensive scalp defects, which results in quicker wound healing with cosmetically superior results, and can be performed safely and comfortably under local anesthesia in the day case setting.
皮肤恶性肿瘤的发病率正在上升，与之相关的是头皮癌数量的增加，这些头皮癌需要进行广泛局部切除（WLE）以确保切除彻底；在处理如此大的缺损时，头皮缺乏弹性的特性带来了特殊挑战。本文报告了68例因清除鳞状细胞癌、非典型纤维黄色瘤、隆突性皮肤纤维肉瘤和黑色素瘤皮肤癌而进行广泛局部切除后出现大面积头皮缺损的病例。这些病例在一个中心接受局部麻醉治疗，采用延长头皮瓣主要用于闭合由此产生的缺损，头皮瓣供区无需使用皮肤移植。延长头皮瓣是治疗大面积头皮缺损的一种安全且可重复的解决方案，它能使伤口愈合更快，美容效果更佳，并且可以在日间手术环境下于局部麻醉状态下安全舒适地进行。
