游离串联皮瓣修复颅骨外露头皮缺损的应用

摘要 目的 探讨合并颅骨外露的大面积头皮缺损的修复方法。方法 应用游离前臂皮瓣及游离股前外侧皮瓣,串联后修复外伤致合并骨外露的头皮缺损7例。将前臂皮瓣血管蒂近端与甲状腺上动脉和颈内静脉吻合,远端与股前外侧皮瓣血管蒂吻合。无骨外露的缺损用游离植皮修复。结果 7例皮瓣存活良好,修复的头皮外观良好,质地柔软。结论 将游离前臂皮瓣和股前外侧皮瓣串联移植,修复大面积头皮缺损临床效果满意。

Application of free-tandem flap in the repair of scalp defect with exposed cranium

Objective To research the method of repairing large area scalp defect with exposed cranium. Methods Seven patients admitted from July 2005 to December 2012 were included in the study. Free-tandem flap comprising forearm flap and anterolateral thigh flap were applied in the repair of wide area scalp defect with exposed cranium in 7 patients. The proximal end of pedicle in forearm flap was anastomosed with superior thyroid artery and internal jugular vein. The distal end of pedicle in forearm flap was anastomosed with pedicle in anterolateral thigh flap. The non-skull- exposure area was repaired with skin grafting. Results All free-tandem flap survived weU in 7 cases, with satisfactory appearance and texture. Conclusion Application of free-tandem flap comprising forearm flap and anterolateral thigh flap is an effective approach to repair wide area scalp defect with exposed cranium, and could achieve a good result.