颅骨修补术后皮瓣坏死与钛网外露原因分析及防治  

Analysis of cause of necrosis of skin flap and titanium mesh exposure after cranioplasty and their prevention

作　　者：徐中[1] 刘惠祥[1] 沈鸟松[1] 高嵘[1] 邱耀忠 钱晓波[1] 李建[1] 

机构地区：[1]张家港市第一人民医院神经外科,江苏215600

出　　处：《中国临床神经外科杂志》2015年第1期28-30,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅骨修补术后皮瓣坏死与钛网外露的原因及防治措施。方法回顾性分析11例颅骨缺损修补术后皮瓣坏死、钛网外露患者的临床资料,7例保留钛网,分别采取换药、减张后直接缝合、咬除外露钛网后缝合及转移皮瓣等措施修复;4例取出钛网后坏死皮瓣清创缝合。结果 11例患者坏死处皮瓣均愈合。7例保留钛网修复皮瓣的病例随访2~24个月,未再发生皮瓣坏死、钛网外露。4例取出钛网病例中,2例1年后再行数字化成形钛网修补,2例放弃再修补手术。结论颅骨缺损修补术后皮瓣坏死、钛网外露通过合理治疗可以保留钛网修复皮瓣,但对排异引起或发生化脓性感染病例,应及时取出钛网。Objective To explore the cause of necrosis of the skin flap and titanium mesh exposure after cranioplasty and method to prevent them. Methods The clinical data of 11 patients with skin flap necrosis and titanium mesh exposure after the cranioplasty were analyzed retrospectively. Titanium meshes were kept in 7 patients who were cured by different ways including the change of dressing, relaxation suture, suture after removing exposed titanium mesh, transfering flap and so on. The exposed titanium meshes were removed and the debridement was performed in 4 patients. Result All the patients were healed. Conclusion The titanium meshes may be reserved and the skin flaps may be repaired by the proper treatment in some patients with necrosis of the flap and titanium mesh exposure after cranioplasty. The titanium meshes should be removed in the patients with necrosis of the skin flaps caused by the graft ejective reaction or purulent infection.

关 键 词：颅骨缺损修补术 术后并发症 皮瓣坏死 钛网外露 治疗 

分 类 号：R628[医药卫生—整形外科] R651.11[医药卫生—外科学]