Görüntüleme
28
İndirme
3
Objective: Scalp defects may occur following trauma, radiotherapy, oncologic resection, and recurrent surgeries. The hair-bearing scalp has a dual role, which consists of protecting the calvarium and contributing to aesthetic appearance. While the “reconstructive ladder” approach may be used to close small and medium-sized scalp defects, it is not the case for larger ones involving the calvarium or with a radiation therapy history. The aim of this study is to present cases operated due to complex scalp defects, analyze complications, and discuss the choice of reconstruction. Material and Methods: The study consists of 14 patients who were operated between December 2017 and August 2019 due to a complex scalp defect. Patient were evaluated according to age, gender, etiology, radiation therapy history, defect size and location, reconstruction steps, cranioplasty and duraplasty options, type of free flap, recipient artery, vein graft requirement, and complications. Results: The mean age of patients, which consists of 11 men and three women, was 56.7 years. The etiology for scalp defects included basosquamous carcinoma, squamous cell carcinoma, giant basal cell carcinoma, atypical meningioma, glioblastoma multiforme, angiosarcoma, and anaplastic oligodendroglioma. The defect involved the full thickness of calvarium in nine cases and pericranium in five cases. Cranioplasties were made with rib graft (n=1), bone graft (n=1), and titanium mesh (n=7). Free flaps used for reconstruction were musculocutaneous latissimus dorsi (LD) (n=4), LD muscle (n=3), anterolateral thigh (ALT) (n=4), musculocutaneous ALT (n=1), vastus lateralis muscle (1), and rectus abdominis muscle (n=1). Flap loss was not observed. Complications occurred in four of the patients; include a partial graft loss, a wound dehiscence, seroma, and an unsatisfactory esthetic result. Conclusion: Free tissue transfers rather than local flaps should be opted to reconstruct complex scalp defects, as failure of the latter, could create much greater defects, and worse consequences. There are many options for proper reconstruction, and it is essential to select the appropriate one, taking into account the comorbid conditions of each case.
Purpose: After trauma, radiotherapy, oncological resection and repeated surgeries, skin defects may occur. The hairy head skin has two roles, which is to preserve the calvary and contribute to the aesthetic appearance. While the "reconstructive stairs" approach can be used to remove small and medium-sized head skin defects, the larger ones containing calvaryum or the radiation therapy history are not applicable. The purpose of this study is to present cases that have been operated due to complex head skin defects, to analyze complications and to discuss the choice of reconstruction. Tools and Methods: The study consists of 14 patients operated due to complicated headache defects between December 2017 and August 2019. Patients have been evaluated in terms of age, gender, etiology, radiation treatment history, defect size and location, reconstruction stages, cranioplasty and duraplasty options, free flep type, receiver artery, venous greft demand and complications. Results: The average age of patients consisting of ten men and three women was 56.7. The etiology of scalp defects included basoscuamose carcinoma, squamose cell carcinoma, giant basal cell carcinoma, angiyosarcoma, atypic menenjiyoma, glioblastoma multiforme and anaplastic oligodendroglioma. The defects contained full thickness calvaryum in nine cases and pericranium in five cases. The cranioplasty was made with a belly greff (n = 1), a bone greff (n = 1) and titanium shell (n = 7). The free fleepers used for reconstruction were muskulocutanous latissimus dorsi (n = 4), latissimus dorsi muscle (n = 3), anterolateral swelling (n = 4), muskulocutanous anterolateral swelling (n = 1), vastus lateralis muscle (n = 1) and rektus abdominis muscle flebi (n = 1). The loss was not observed. Four of the patients had complications, which were partial loss of the transplant, wound separation, seroma and unsatisfactory aesthetic result. The result: Free tissue transfers instead of local fleps should be selected for the reconstruction of complex scalp defects, because the failure of local fleps can result in much greater defects and worse results. There are many options for proper reconstruction, and it is important to choose the right one taking into account the comorbid conditions of each vacancy. (SETB 2020-10-199)
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
Makale Detay 
Benzer Makaleler
PDF Görüntüle
Dergi Bilgisi
Eseri Dinleyin
Alıntı Yap
Bu Sayfayı Yazdırın
Paylaş
Mendeley
