头皮缺损合并颅骨外露的皮瓣修复方法探讨

目的:探讨头皮缺损合并颅骨外露的皮瓣修复方法。方法:自2008年1月～2013年3月共收治头皮缺损合并颅骨外露30例,行局部头皮瓣、轴型头皮瓣转移结合皮片移植、上臂带蒂皮瓣修复。头皮缺损最大面积20cm×15cm,颅骨外露最大面积14cm×10cm。结果:共切取皮瓣34块、供瓣区植皮10例。皮瓣皮片均成活良好,术后随访6个月～4年,效果满意。结论:局部头皮旋转皮瓣是修复较小面积(直径小于7cm)头皮缺损优选方法,轴型头皮瓣修复较大面积(直径大于7cm)头皮缺损伴颅骨外露是有效方法,头皮缺损合并面部皮肤缺损行同侧上臂带蒂皮瓣修复也是较理想的方法。

Investigate of repair of scalp defect and skull exposure by skin flaps graft

Objective To discuss different procedures of repair of scalp defect and skull exposure by skin flap s graft. Methods From 2008 to 2013 ,different methods were used to repair 30 cases with scalp defect and skull exposure after wound, burns, tumor or other occasions. Some cases had been repaired by scalp arbitrarily flap transposition,axle skin flap bonding free skin graft or skin flap of upper arm. The maximal scalp defect size was 20cmx15cm, the maximal skull exposure size was 14cmx10cm. Results 34 flaps survived after operation.Followed up in the next 6 months to 4 years, with satisfactory results. Conclusions The arbitrarily rotation flap is an ideal method when the defect is small （diameter〈7cm）.The axle skin flap bonding free skin graft is an effective method to repair large scalp defect and skull exposure （diameter〉7cm）. Scalp defect merging facial line ipsilateral upper arm pedicle skin flap to repair skin defect is also a relatively ideal method.