Introducing the Rectus Fascia Scalp Augmentation Technique: A New Method for Improving Scalp Durability in Cranioplasty Reconstruction.
J Craniofac Surg
; 29(7): 1733-1736, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-29944559
ABSTRACT
OBJECTIVE:
Patients with cranioplasty in need of skull reconstruction are at increased risk of complications when presenting with abnormally thin scalps. As such, the authors sought to develop and investigate a new technique for scalp augmentation using autologous rectus fascia grafts (ARFGs) for prevention of implant extrusion and long-term scalp durability.METHODS:
A retrospective review of our database, consisting of 450 consecutive cranial reconstructions from 2012 to 2017, was performed under institutional review board approval. Selection criteria included all adult patients requiring implant-based cranioplasty reconstruction and concomitant scalp augmentation using ARFGs. All long-term outcomes were reviewed for scalp-related complications and are presented here.RESULTS:
In total, 12 consecutive patients receiving ARFGs were identified. Average follow-up was 10 months (rangeâ=â2-17 months). Average graft size and dimension was 82âcm (rangeâ=â12-360âcm). All patients (nâ=â12) underwent concomitant cranioplasty reconstruction and had a history of at least 5 or greater previous neurocranial operations. Six patients had radiation therapy prior to cranioplasty. Two major complications (2/12, 17%) were identified related to deep, recurrent intracranial infections. More importantly, none of the patients (nâ=â12) in this study cohort developed scalp breakdown and/or implant extrusion in the areas of rectus fascia scalp augmentation.CONCLUSION:
The use of ARFGs for underlay scalp augmentation appears to be both safe and reliable based on our preliminary experience. This new approach is extremely valuable when performing large-size cranioplasty reconstruction in patients with abnormally thin scalps, an extensive neurosurgical history, and/or suboptimal tissue quality. Furthermore, this method has been successful in avoiding free tissue transfer and/or staged tissue expansion as first-line surgery in our complicated cranioplasty population.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Prótesis e Implantes
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Cuero Cabelludo
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Cráneo
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Expansión de Tejido
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Procedimientos de Cirugía Plástica
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Fascia
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Craniofac Surg
Asunto de la revista:
ODONTOLOGIA
Año:
2018
Tipo del documento:
Article