老年人大面积头皮缺损伴颅骨外露的修复重建

Reconstructing large scalp defect with pedicled skin flap in elderly people

目的探讨应用头颈部带蒂皮瓣修复老年人大面积头皮缺损伴骨外露的有效性和安全性。方法对12例头皮大面积缺损伴颅骨外露的老年患者应用局部带蒂皮瓣或远位斜方肌肌皮瓣进行修复。根据皮瓣存活、手术并发症及随访结果评定最终效果。结果本组共13个带蒂皮瓣修复,其中11个局部带蒂皮瓣和2个斜方肌肌皮瓣。除4例患者发生血肿、皮瓣远端部分坏死等并发症外,其余8例均Ⅰ期愈合。结论灵活应用各种局部带蒂皮瓣修复老年人大面积头皮缺损伴颅骨外露,可以获得良好的效果。

Objective To explore the effectiveness and safety of head or neck pedicled flaps for the repair of LSSDs with SBE/D in elderly patients. Methods Twelve elderly patients with large scalp defects and skull exposure were repaired with local pedicled scalp flaps or distant trapezius myocutaneous flaps. The main outcomes, including flap survival, procedure-related complications, and foUow-up results were examined. Results The twelve wotmds were repaired using 13 pedicled flaps, including local scalp flaps （ n =11） and trapezius myocutaneous flaps （ n = 2）. All patients healed primarily except for 4 patients with hematoma and distal partial flap necrosis. Conclusion Flexible application of various local pedicle skin flap to repair the old large scalp defect with skull exposure can obtain good effect.