手术治疗颅骨修补术后钛网外露16例临床体会  

Surgical treatment of titanium mesh exposure after cranioplasty: a report of 16 cases

作　　者：邵明辰 程鹏 崔彦魁[1] SHAO Ming-chen;CHENG Peng;CUI Yan-kui(Jiaozuo Second People's Hospital,Henan Province,454000,China)

机构地区：[1]焦作市第二人民医院

出　　处：《中国医疗美容》2019年第11期28-31,共4页China Medical Cosmetology

摘　　要：目的探究分析眼睑肿物切除术后造成的组织缺损创面,使用局部皮瓣转移修复的效果及预后情况。方法回顾性分析2015年1月~2019年1月我院16例颅骨修补术后钛网外露患者的临床资料。术前行清创术,控制局部感染、清创残腔积液,结合负压封闭引流促进创面肉芽组织生长,根据钛网外露大小、面积选择直接缝合及皮瓣转移修复,术后行双管引流。结果本组16例患者中,1例患者钛网外露宽度小于1cm,清创后行皮下松解后进行直接缝合后痊愈。6例患者行局部皮瓣转移治疗,术后痊愈5例,皮瓣远端坏死1例,加强创面护理后愈合。5例患者采用S型皮瓣转移修复,术后创面均愈合良好。4例患者采用A-T转移皮瓣治疗,术后1例修复失败后行钛网拆除。术后随访6~36个月,创面愈合良好。结论颅骨修补术后钛网外露需保证创面条件良好,根据创面选择合适的皮瓣修复,可获得理想的修复效果。Objective To explore the operative scheme of titanium mesh exposure after cranioplasty.Methods The clinical data of 16 patients with titanium mesh exposure after cranioplasty in our hospital from January 2015 to January 2019 were analyzed retrospectively.Before the operation,debridement was performed to control local infection and residual cavity effusion.Combined with vacuum sealing drainage,granulation tissue growth was promoted.According to the size and area of titanium mesh exposure,direct suture and flap transfer repair were selected.After the operation,double drainage was performed.Results Among the 16 patients,1 patient had titanium mesh less than 1 cm in width.After debridement,subcutaneous release was performed and direct suture was performed.6 cases were treated with local flap transfer,5 cases were cured,1 case was necrosis of the distal end of the flap,and the wound was healed after intensive nursing.Five patients were treated with S-shaped flap,and the wounds healed well.Four patients were treated with A-T flap,and one patient was removed with titanium mesh after failure.After 6-36 months follow-up,the wound healed well.Conclusion The titanium mesh exposure after cranioplasty needs to ensure the good condition of the wound..

关 键 词：钛网外露 皮瓣 颅骨修补术 负压封闭引流术 

分 类 号：R65[医药卫生—外科学]