游离皮瓣在颅骨外露的头皮缺损中的应用

Repairing scalp defect with skull exposure with free flap and microsurgery technique

目的:报告应用游离皮瓣修复头皮缺损致颅骨外露的方法和临床疗效。方法:本组5例患者年龄5～58岁,平均35岁,因创伤、肿瘤等原因造成头皮部分缺损并颅骨外露,缺损面积在8cm×10cm～15cm×10cm;缺损部位为颞部、顶部及额部。分别选用游离胸脐皮瓣、旋股外侧皮瓣和胫后动脉皮瓣等移植修复创面。结果:本组5例患者移植皮瓣Ⅰ期成活,其中2例移植皮瓣后行头皮扩张术,术后扩张头皮全部覆盖创面,毛发生长良好。术后随访6～18个月,患者皮瓣除臃肿外,创面Ⅰ期愈合,外形效果好。结论:采用吻合血管的游离皮瓣移植修复颅骨缺损,可以在短期内完全覆盖裸露的颅骨,确保了颅骨的成活。皮瓣成活后,可以Ⅱ期手术修整或头皮扩张术,既修复创面又能恢复头部外观,是一种理想的修复方式。

Objective To explore the treatment effect of free flap and microsurgery technique for repairing scalp defect with skull exposure. Methods Review the reconstruction method of scalp defect with skull exposure in 5 cases using free flap, including free thoraconavel flap, anterolateral thigh flap and posterior tibial artery flap. Results All the grafts and flap were survived and satisfactory results were get after 6～18 months follow-up. Conclusion It is an effective technique for repairing scalp defect with skull exposure using free flap and microsurgery technique.It deserves wide clinical application.