Reconstruction of Long Term Neglected, Complicated Scalp and Calvarial Defects with Subdural Abscess Using Latissimus Dorsi Myocutaneous Free Flap: A Case Report.
- Author:
Yongjoon NOH
1
;
Sang Hyung LEE
;
Eui Cheol JEONG
;
Ji Ung PARK
Author Information
1. Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Calvarial defect;
Latissimus dorsi myocutaneous free flap
- MeSH:
Abscess;
Ambulatory Care Facilities;
Arteries;
Craniotomy;
Emergencies;
Follow-Up Studies;
Free Tissue Flaps;
Humans;
Middle Aged;
Postoperative Complications;
Scalp;
Seizures;
Spasm;
Temporal Arteries;
Wound Healing
- From:Journal of the Korean Cleft Palate-Craniofacial Association
2011;12(2):107-110
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: There have been few case reports regarding treatment plans for long-term, neglected scalp defects and calvarial defects with subdural abscess. The purpose of this case report is to present our experience with a free latissimus dorsi musculocutaneous flap for scalp and calvarial defects and to discuss flap options in comparison with a literature review. METHODS: A 60-year-old man who fell down from a four-story-height that resulted in a craniotomy in 1979; he visited our outpatient clinic for a chronic, purulent scalp and calvarial defects with unidentified artificial bone. The artificial bone was removed by a neurosurgeon and reconstructed with a free latissimus dorsi musculocutaneous flap. The deep temporal artery was used as a recipient artery. The postoperative flap status was excellent until the 6th day post-operation when the patient experienced a seizure, and an arterial insufficiency occurred at the flap probably due to an arterial spasm. Emergency exploration with arterial re-anastomosis was performed and the flap status was stabilized. RESULTS: Complete wound healing was achieved after 3 weeks without infectious and systemic postoperative complications. During the 6 month follow-up period, there were no complications. CONCLUSION: We suggest the latissimus dorsi myocutaneous free flap as a good treatment option for a chronic, purulent, complicated scalp with calvarial defect, as a well as treatment for an acute traumatic defect.
