Reconstruction of the Scalp Defect with Advancement of Scalp Flap and Forehead Lifting and Percutaneous External Fixation with Miniscrews-A Case Report

以轉移皮瓣及前額整形術及迷你骨釘之經皮外固定術重建頭皮缺損－病例報告

張世幸(Shih-Hsin Chang) ； 蕭弘道(Hunhg-Tau Hsiao) ； 歐聖運(Shuan-Yuan Ou)

《中華民國整形外科醫學會雜誌》 9卷1期 (2000/03) Pp. 73-79

https://doi.org/10.7096/JPSA.200003.0073

摘要

對於一位重建整形外科醫師而言，對於頭皮缺損之重建仍是一項有趣的挑戰。頭皮是保護頭部的第一道防線，若有頭皮缺損勢必影響其下方之頭骨甚至腦部，造成生命的重大威脅。重建頭皮缺損的方法包括：直接縫合、植皮術、局部皮瓣、轉移皮瓣、根蒂皮瓣及自由皮瓣。然而以上所列之方法皆仍未臻完善，尤其是術後的部份禿髮的現象，而其他缺點還包括：手術時間較長、出血量大、需要供皮區等。
一位男性患者因頭部外傷合併頭皮約6×6公分之缺損，我們使用頭皮之轉移皮瓣及前額整形術合併迷你骨釘之經皮外固定術，成功的在一次手術後關閉缺損。術後患者恢復良好，並且在頭皮僅留下最小的傷疤，同時也使患者在外觀上較為年輕，可謂一舉而數得之重建方法。

並列摘要

The scalp is a complex structure with multiple layers of tissue, which prvoides the coverage and protection to the skull and brains Therefore, a full-thickness defect of the scalp is a serious condition, which may develop to a life4hreatening situation. There are many methods of reconstruction to the full-thickness defect of scalp, including the rotation flap, transposition flap with skin graft, island pedicle flap with skin graft, and even free flaps Here, we develop a method which combined the wide undermining and advancing of the scalp with the percutaneous external fixation with miniscrews to the outer table of skull and a forehead-lifting, and closes a 6×6 cm scalp defect in one-stage operation, The result is satisfactory and no major complication occurs.

並列關鍵字

scalp defect ； advancing scalp flap ； forehead-lifting ； percutaneous external fixation with miniscrews