大面积头皮缺损及颅骨外露的显微外科修复  

Reconstractive treatment of a large scalp defect and skull exposure

作　　者：李小静[1] 宁金龙[1] 高学宏[1] 张林[1] 朱飞[1] 孔祥安[2] 

机构地区：[1]安徽医科大学第一附属医院整形外科,230022 [2]合肥市第二人民医院骨科

出　　处：《中华显微外科杂志》2004年第1期30-31,共2页Chinese Journal of Microsurgery

摘　　要：目的　探讨大面积头皮缺损及颅骨外露修复的手术方法的选择。　方法　自 1986年以来 ,共收治大面积头皮缺损及颅骨外露 3 6例 ,应用逆流颞顶筋膜瓣结合中厚皮片移植、下斜方肌肌皮瓣移植修复及轴型头皮瓣结合皮片移植修复 ,创面最大 2 6cm× 2 4cm ,颅骨外露最大面积 2 2cm× 18cm。　结果　共切取皮瓣、筋膜瓣及肌皮瓣 3 4块 ,其中 1例局部头皮瓣因缝合有张力 ,边缘裂开 ,换药后再次用局部小皮瓣修复痊愈。 1例下斜方肌肌皮瓣远端 4cm表皮坏死 ,行补充植皮治疗后愈合 ,其余皮瓣均完全成活 ,术后经半年～ 1年随访 ,效果满意。　结论　逆流颞顶筋膜瓣是头皮肿瘤切除后顶额部骨外露修复的有效方法之一 ;下斜方肌肌皮瓣则是修复全头皮撕脱大面积颅骨外露较为理想的方法。Objective To explore the methods of repairing a large scalp defect and skull exposure. Methods From 1990,36 cases were treated by the temporoparietal fascial flaps transfer with split skin graft,the lower trapezius myocutaneous flaps transfer and axial scalp flaps transfer with split skin graft.,the maximal scalp defect size was 26cm×24cm,the maximal skull exposure size was 22cm×18cm. Results AU 34 cases obtained complete success with satisfactory results,one case of necrosis in the distal of the flap and delayed wound healing. Conclusion The temporoparietal fascial flap is an efficatious and convenient method to repair severe soft tissue defects in the fronto-parieto-tempral region,the superlower trapezius myocutaneous flap is an ideal method to repair the large skull exposure.

关 键 词：头皮缺损 颅骨外露 显微外科 手术方法 皮瓣移植术 

分 类 号：R651.1[医药卫生—外科学]