Reconstruction of Chronic Complicated Scalp and Dural Defects Using Acellular Human Dermis and Latissimus Dorsi Myocutaneous Free flap.
10.7181/acfs.2015.16.2.80
- Author:
Jun Hee LEE
1
;
Seok Keun CHOI
;
Sang Yoon KANG
Author Information
1. Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine, Seoul, Korea. nuelk@nate.com
- Publication Type:Case Report
- Keywords:
Dura mater;
Acellular dermis;
Free tissue flaps
- MeSH:
Acellular Dermis;
Arachnoid;
Cerebrospinal Fluid;
Cerebrum;
Decompressive Craniectomy;
Dermis*;
Dura Mater;
Female;
Free Tissue Flaps*;
Humans*;
Intracranial Hemorrhages;
Methicillin Resistance;
Middle Aged;
Scalp*;
Staphylococcal Infections;
Superficial Back Muscles*;
Suppuration;
Temporal Arteries;
Wounds and Injuries
- From:Archives of Craniofacial Surgery
2015;16(2):80-83
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present reconstruction of a complicated scalp-dura defect using acellular human dermis and latissimus dorsi myocutaneous free flap. A 62-year-old female had previously undergone decompressive craniectomy for intracranial hemorrhage. The cranial bone flap was cryopreserved and restored to the original location subsequently, but necessitated removal for a methicillin-resistant Staphylococcal infection. However, the infectious nidus remained in a dermal substitute that was left over the cerebrum. Upon re-exploration, this material was removed, and frank pus was observed in the deep space just over the arachnoid layer. This was carefully irrigated, and the dural defect was closed with acellular dermal matrix in a watertight manner. The remaining scalp defect was covered using a free latissimus dorsi flap with anastomosis between the thoracodorsal and deep temporal arteries. The wound healed well without complications, and the scalp remained intact without any evidence of cerebrospinal fluid leak or continued infection.
