头皮缺损合并颅骨外露或缺损的皮瓣修复  

Repair of scalp defect and skull exposure or skull defect by skin flaps graft

作　　者：肖目张[1] 杨兴华[1] 黄晓元[1] 龙剑虹[1] 

机构地区：[1]中南大学湘雅医院烧伤整形科,湖北长沙410008

出　　处：《创伤外科杂志》2008年第4期308-310,共3页Journal of Traumatic Surgery

摘　　要：目的探讨头皮缺损合并颅骨外露或缺损的皮瓣修复方法。方法自1997年2月-2007年7月共收治头皮缺损合并颅骨外露或缺损87例，行多个局部头皮瓣转移或双侧旋转皮瓣转移、轴型头皮皮瓣转移结合皮片移植、吻合血管的游离皮瓣移植修复手术。头皮缺损最大面积22．3cm×25．8cm，颅骨外露最大面积21．3cm×15．8cm，颅骨缺损最大面积11．7cm×8．4cm。结果共切取皮瓣及肌皮瓣87块，其中1例背阔肌肌皮瓣坏死，行颅骨钻孔肉芽生长植皮后愈合。其余皮瓣皮片均完全成活，术后随访6个月-4年，效果满意。结论轴型头皮皮瓣转移是修复大面积头皮缺损伴颅骨外露或颅骨缺损的有效方法之一。多个局部头皮瓣转移或双侧旋转皮瓣转移是修复较小范围头皮缺损并颅骨外露或缺损的较理想的方法。Objective To discuss different procedures of repair of scalp defect and skull exposure or skull defect by skin flaps graft. Methods From 1997 to 2007 , Different methods were used to repair 87 cases with scalp defect and skull defect or skull exposure after trauma, electric bums, scar ulcer and tumor or other occasions. Some cases had been repaired by multiple scalp flaps transposition or bilateral rotation skin flap graft, other cases had been repaired by axial scalp flaps transfer with split skin graft, and still other cases by free skin flaps graft. The maxima/ scalp defect size was 22.3cm × 25.8cm, the maximal skull exposure size was 21.3 cm × 15.8 cm, the maximal skull defect size was 11.7cm × 8.4cm. Results A total of 86 cases obtained complete success with satisfactory results, 1 case of necrosis of the latissimus dorsal myocutaneous flap and delayed wound healing. Conclusion The axial scalp flap transfer with split skin graft is an effective and convenient method to repair large scalp defect and skull defect or skull exposure,the multiple scalp flaps transposition or bilateral rotation skin flap graft is an ideal method when the defect is small.

关 键 词：头皮缺损 颅骨缺损 皮瓣修复 

分 类 号：R651[医药卫生—外科学] R622.1[医药卫生—临床医学]