保留钛网清创并皮瓣转移修复颅骨成形术后钛网外露的治疗体会

The treatment experience of crandnioplasty with titanium mesh exposure after debridement with retaining titanium mesh and skin flap transferring

目的:探讨在保留钛网的情况下,局部彻底清创后行皮瓣转移修复颅骨成形术后钛网外露的治疗效果。方法:选择2017年2月—2020年11月收治的颅骨修补术后钛网外露患者6例,入院后床边清洁换药,直至外露钛网局部渗液减少或无渗液,择期手术,方式为先局部扩创,然后剪开外露钛网行钛网下及周围组织彻底清创后再予钛网复位,最后行皮瓣转移修复创面。结果:6例患者创面均一期愈合,随访最长者48个月,未再复发。结论:颅骨成形术后小面积钛网外露患者适合保留钛网清创并皮瓣转移修复的手术方案,在彻底清创的前提下保留钛网,避免了去除钛网及再次修补给患者带来的身心损害及经济负担,且简单易行。

Objective:To explore the treatment effect of cranioplasty with titanium mesh exposure after local and thogrough debreidement by skin flap transferring,in the case of retaining titanium mesh.Methods:Six patients with exposed titanium mesh after cranioplasty who were admitted from February 2017 to November 2020 were selected.After admission,the bedside was cleaned and dressing changed until the local exudation of the exposed titanium mesh was reduced or no longer.Then,the exposed titanium mesh was cut,and the tissues under the titanium mesh and surrounding tissues were thoroughly debridement,and then the titanium mesh was repositioned.Finally,the skin flap was transferred to repair the wound.Results:The wounds of six patients were primary healing,and the patients with the longest follow-up did not recur for 48 months.Conclusion:The patients with a small area of titanium mesh exposed after skull formation are suitable for the operative program of retaining the tianium mesh for debridement and tansferring the skin flap.On the premise of thorough debridement,retaining titanium mesh could aviod the physical,mental and financial burden for patients by removing the titanium mesh and reparing it agin.This surgical method is simple and well worth popularizing at the grassroots level.