| Reconstruction of Long Term Neglected, Complicated Scalp and Calvarial Defects with Subdural Abscess Using Latissimus Dorsi Myocutaneous Free Flap: A Case Report. |
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Yongjoon Noh, Sang Hyung Lee, Eui Cheol Jeong, Ji Ung Park |
1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
2Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
3Department of Plastic and Reconstructive Surgery, Seoul National University Boramae Medical Center, Seoul, Korea. alfbskan@gmail.com |
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| 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. |
| Keywords:
Calvarial defect; Latissimus dorsi myocutaneous free flap |
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