Application of the pedicled pericranial flap in the treatment of chronic cerebrospinal fluid leakage
10.3760/cma.j.cn114453-20211026-00418
- VernacularTitle:带蒂颅骨膜瓣在慢性脑脊液漏治疗中的应用
- Author:
Tingting XIANG
1
;
Weimin WU
;
Lixia WEN
;
Yapeng LIU
;
Weigang HU
;
Ming XIA
Author Information
1. 三峡大学人民医院（宜昌市第一人民医院）烧伤整形外科，宜昌 443000
- Keywords:
Cerebrospinal fluid leak;
Pedicled pericranial flap;
Dural defect;
Reconstructive surgical procedures
- From:
Chinese Journal of Plastic Surgery
2022;38(7):787-791
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of the pedicled pericranial flap in the treatment of chronic cerebrospinal fluid leakage.Methods:A retrospective analysis was conducted based on the clinical data of patients with cerebrospinal fluid leakage after craniocerebral surgery who were admitted to the First People’s Hospital of Yichang from April 2016 to October 2020. The necrotic tissues were thoroughly removed. The dural defects were repaired with pedicled pericranial flaps, and soft tissue defects were repaired with local flaps. The incision was covered with negative pressure closed drainage dressing, and negative pressure was maintained at -50 to -80 mmHg (1 mmHg=0.133 kPa). Cerebrospinal fluid leakage, defect repair, and related complications were observed in postoperative follow-up.Results:A total of five patients (three males and two females, aged 49-65 years) were included. All patients had postoperative composite tissue defects with local infection after craniocerebral surgery, lasting two months to 12 years. The size of the postoperative dural defect ranged from 1.5 cm × 2.0 cm to 2.5 cm × 3.0 cm. The size of the scalp soft tissue defect ranged from 2.0 cm × 2.0 cm to 3.0 cm × 6.0 cm. The size of the pericranial flap ranged from 2.0 cm × 3.0 cm to 3.0 cm × 3.5 cm, and the local flap ranged from 8.0 cm × 13.0 cm to 12.0 cm × 16.0 cm. The cerebrospinal fluid leakage was still observed in one patient at 5 d after the surgery and was treated with continuous lumbar pool puncture for cerebrospinal fluid drainage, which healed one week later. One patient suffered from poor healing of the flap incision, which healed after two weeks of outpatient dressing changing. At the postoperative follow-up of 3 to 17 months, none had any further cerebrospinal fluid leakage, and no other complications such as intracranial infection, loss of frontal lines, scalp numbness, and necrosis occurred.Conclusions:Repair of dural defects by pedicled pericranial flaps can treat chronic cerebrospinal fluid leakage with less damage to the donor site and fewer complications.
