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目的探讨不同带蒂皮瓣在头皮恶性肿瘤术后缺损I期修复与重建中的作用,评价其临床效果。方法用邻近头皮瓣转移加植皮法、逆流颞顶筋膜瓣转移加植皮法,下斜方肌肌皮瓣转移法一期修复头皮缺损伴颅骨外露36例。结果共切取皮瓣,筋膜瓣,肌皮瓣42块,除1例下斜方肌肌皮瓣远端表皮坏死经换药后愈合,其余皮瓣完全成活,功能及外观均满意,随访3月～3年无复发。结论邻近头皮瓣转移加植皮术对术后较小面积头皮缺损伴颅骨外露效果良好,逆流颞顶筋膜瓣加植皮法适应于额顶部头皮肿瘤切除后骨外露修复的有效方法之一,而下斜方肌肌皮瓣可满足较大面积头皮缺损伴颅骨外露的修复。
Objective To investigate the role of different pedicle flap in the repair and reconstruction of stage I defect of scalp malignant tumor and evaluate the clinical effect. Methods A total of 36 cases of scalp defect with skull exposure were repaired with adjacent scalp flap transfer and grafting, reverse temporal TMT fascia flap transfer and skin grafting, and lower trapezius myocutaneous flap transfer. Results A total of 42 flaps, fascia and myocutaneous flaps were obtained. Except for 1 case, the distal epidermis necrosis of the trapezius myocutaneous flap healed after dressing change. The remaining flaps survived fully and the function and appearance were satisfactory. Month ~ 3 years without recurrence. Conclusions Proximal scalp flap transplantation and skin grafting have a good effect on scalp defect with scalp. The reverse temporal TMT fascia flap plus skin graft method is one of the effective methods to repair the scalp bone after partial topical scalp tumor resection. Lower trapezius muscle myocutaneous flap to meet the larger area of scalp defects with skull exposed repair.