Department of Burn and Plastic Surgery, Jiangyin Hospital Affiliated to School of Medicine Southeast University, Jiangyin, Jiangsu, China.
Department of Nursing, Jiangyin Hospital Affiliated to School of Medicine Southeast University, Jiangyin, Jiangsu, China.
Acta Neurochir (Wien). 2022 Dec;164(12):3101-3106. doi: 10.1007/s00701-022-05365-w. Epub 2022 Oct 10.
Titanium mesh exposure after cranioplasty is a possible complication and is usually managed by mesh removal and flap transfer, but the advantages of the rigid prosthesis are then lost. This study aimed to present our experience with negative pressure wound therapy combined with soft tissue dilation for retaining the titanium mesh in patients with mesh exposure after cranioplasty.
This retrospective study included patients treated between 01/2016 and 05/2019 at the Jiangyin Hospital Affiliated to Southeast University School of Medicine. The wound was cleaned, and a cystic space was created for the tissue dilator, which was used with a self-designed negative pressure dressing. After the target dilation was achieved, the repair was conducted while retaining the titanium mesh.
Eight patients were included (seven males and one female; 53.6 ± 8.8 (range, 43-65) years of age). The exposed mesh area ranged from 1 × 1 to 4 × 5.5 cm. The thinning scalp area around the exposed mesh ranged from 3.6 × 3.8 to 4 × 5.5 cm. Five patients had positive wound cultures and received sensitive antibiotics. The dilator embedding time was 20-28 days. The time of negative pressure wound therapy was 25-33 days. The hospital stay was 30-41 days. Primary wound healing was achieved in all eight patients. There were no signs of recurrence after 6-18 months of follow-up. The cranial CT scans were unremarkable.
Negative pressure wound therapy combined with soft tissue dilation for exposed titanium mesh after cranioplasty might help retain the titanium mesh.
颅骨修补术后钛网外露是一种可能的并发症，通常通过去除金属网和皮瓣转移来处理，但随后就失去了刚性假体的优势。本研究旨在介绍我们使用负压伤口治疗联合软组织扩张术保留颅骨修补术后钛网外露患者钛网的经验。
本回顾性研究纳入了东南大学医学院附属江阴医院于 2016 年 1 月至 2019 年 5 月期间治疗的患者。对伤口进行清洁，并为组织扩张器创建一个囊腔，同时使用自行设计的负压敷料。达到目标扩张后，在保留钛网的情况下进行修复。
共纳入 8 例患者（7 名男性和 1 名女性；53.6±8.8（范围，43-65）岁）。外露的金属网面积从 1×1 到 4×5.5 cm 不等。外露金属网周围变薄的头皮面积从 3.6×3.8 到 4×5.5 cm 不等。5 例患者的伤口培养呈阳性，并接受了敏感抗生素治疗。扩张器嵌入时间为 20-28 天。负压伤口治疗时间为 25-33 天。住院时间为 30-41 天。8 例患者均获得一期伤口愈合。在 6-18 个月的随访中，均未见复发迹象。颅骨 CT 扫描未见异常。
颅骨修补术后钛网外露时，采用负压伤口治疗联合软组织扩张术有助于保留钛网。
