Bui Mai-Anh, Pham Ngoc-Huy, Vu Trung-Truc
Department of Maxillofacial-Plastic-Aesthetic Surgery, Vice Chief of Scientific Research Department, VietDuc University Hospital, 40 Trang Thi, Hanoi, Vietnam.
Department of Oral and Maxillofacial Surgery, Vietnam National University of Medicine and Pharmacy, 144 Xuan Thuy Street, Cau Giay, Hanoi, Vietnam.
JPRAS Open. 2025 Jan 30;44:68-75. doi: 10.1016/j.jpra.2025.01.011. eCollection 2025 Jun.
Scalp thinning and soft tissue atrophy are significant risk factors for prosthetic material exposure after cranioplasty surgery. Reconstruction of the forehead and scalp to ensure functional coverage and aesthetics continues to be challenging.
This prospective study assessed 15 patients with titanium mesh material exposure, scalp thinning, and soft tissue atrophy following cranioplasty from 2020 to 2023 to identify contributory factors. All patients underwent reconstruction with free adipocutaneous anterolateral thigh flap to cover skin defects and fill soft tissue. The results were evaluated based on flap survival, coverage, and symmetry after surgery.
The average age in the study was 40.46 (range 11-68) years, and the male/female ratio was 9/6. From 2020 to 2023, 15 free adipocutaneous anterolateral thigh flaps were used for reconstruction. Complete flap survival was achieved in 93.3 % (14/15) patients with all titanium mesh implants retained. Symmetry and soft tissue hypoplasia correction was achieved in all 15 cases.
Adipocutaneous anterior lateral thigh (ALT) flap is a versatile flap to treat complications following cranioplasty with titanium mesh. The ALT flap provides extensive coverage, reduce the risk of recurrent infections, and create an implant for soft tissue atrophy or skin thinning to restore the scalp's aesthetics.
颅骨修补术后头皮变薄和软组织萎缩是导致修复材料外露的重要危险因素。前额和头皮的重建以确保功能覆盖和美观仍然具有挑战性。
这项前瞻性研究评估了2020年至2023年间15例颅骨修补术后出现钛网材料外露、头皮变薄和软组织萎缩的患者，以确定相关因素。所有患者均接受游离股前外侧脂肪皮瓣重建术，以覆盖皮肤缺损并填充软组织。术后根据皮瓣存活情况、覆盖情况和对称性对结果进行评估。
研究对象的平均年龄为40.46岁（范围11 - 68岁），男女比例为9/6。2020年至2023年，共使用15个游离股前外侧脂肪皮瓣进行重建。93.3%（14/15）的患者皮瓣完全存活，所有钛网植入物均得以保留。15例患者均实现了对称性和软组织发育不全的矫正。
股前外侧脂肪皮瓣是一种用于治疗钛网颅骨修补术后并发症的多功能皮瓣。股前外侧脂肪皮瓣可提供广泛的覆盖，降低反复感染的风险，并为软组织萎缩或皮肤变薄植入材料以恢复头皮美观。
