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Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report

INTRODUCTION AND IMPORTANCE: Management of cranial and scalp defects is always challenging. Complication rates following cranioplasty are still high (10–40 %), including bone graft resorption, infection, and T-mesh implant exposure due to thinning of soft tissue (Yeap et al., 2019; Alkhaibary et al....

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Autores principales: Dung, Vu Thi, Dung, Pham Thi Viet, Anh, Hoang Tuan, Nhan, Nguyen Hop, Vu, Nguyen, Nha, Le Kim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382746/
https://www.ncbi.nlm.nih.gov/pubmed/37343501
http://dx.doi.org/10.1016/j.ijscr.2023.108390
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author Dung, Vu Thi
Dung, Pham Thi Viet
Anh, Hoang Tuan
Nhan, Nguyen Hop
Vu, Nguyen
Nha, Le Kim
author_facet Dung, Vu Thi
Dung, Pham Thi Viet
Anh, Hoang Tuan
Nhan, Nguyen Hop
Vu, Nguyen
Nha, Le Kim
author_sort Dung, Vu Thi
collection PubMed
description INTRODUCTION AND IMPORTANCE: Management of cranial and scalp defects is always challenging. Complication rates following cranioplasty are still high (10–40 %), including bone graft resorption, infection, and T-mesh implant exposure due to thinning of soft tissue (Yeap et al., 2019; Alkhaibary et al., 2020; Cho and Kang, 2017 [1–3]). CASE PRESENTATION: We present a case of a 38-year-old male with autologous bone graft resorption accompanied by thinning of the forehead skin. He underwent cranioplasty with titanium mesh (T-mesh) and scalp reconstruction with an anterolateral thigh (ALT) flap in a single-stage operation. A 2-component ALT flap was used: the skin paddle covered the scalp defect to reduce closure tension, and especially the adipofascial flap lining beneath the forehead skin to increase thickness. Postoperative results were great in terms of coverage function and aesthetics. CLINICAL DISCUSSION: The phenomenon of soft tissue thinning causing titanium mesh exposure is a common complication with a rate of 10–14 % (Yeap et al., 2019; Dong et al., 2020; Maqbool et al., 2018 [1, 4, 5]). Using adipofascial ALT flap as a sub-scalp filler material has many advantages over the latissimus dorsi (LD) flap to increase scalp thickness but still ensure aesthetics. CONCLUSION: The results suggest a new direction in using adipofascial ALT flap as filler material to increase scalp thickness to reduce T-mesh exposure following cranioplasty.
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spelling pubmed-103827462023-07-30 Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report Dung, Vu Thi Dung, Pham Thi Viet Anh, Hoang Tuan Nhan, Nguyen Hop Vu, Nguyen Nha, Le Kim Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Management of cranial and scalp defects is always challenging. Complication rates following cranioplasty are still high (10–40 %), including bone graft resorption, infection, and T-mesh implant exposure due to thinning of soft tissue (Yeap et al., 2019; Alkhaibary et al., 2020; Cho and Kang, 2017 [1–3]). CASE PRESENTATION: We present a case of a 38-year-old male with autologous bone graft resorption accompanied by thinning of the forehead skin. He underwent cranioplasty with titanium mesh (T-mesh) and scalp reconstruction with an anterolateral thigh (ALT) flap in a single-stage operation. A 2-component ALT flap was used: the skin paddle covered the scalp defect to reduce closure tension, and especially the adipofascial flap lining beneath the forehead skin to increase thickness. Postoperative results were great in terms of coverage function and aesthetics. CLINICAL DISCUSSION: The phenomenon of soft tissue thinning causing titanium mesh exposure is a common complication with a rate of 10–14 % (Yeap et al., 2019; Dong et al., 2020; Maqbool et al., 2018 [1, 4, 5]). Using adipofascial ALT flap as a sub-scalp filler material has many advantages over the latissimus dorsi (LD) flap to increase scalp thickness but still ensure aesthetics. CONCLUSION: The results suggest a new direction in using adipofascial ALT flap as filler material to increase scalp thickness to reduce T-mesh exposure following cranioplasty. Elsevier 2023-06-09 /pmc/articles/PMC10382746/ /pubmed/37343501 http://dx.doi.org/10.1016/j.ijscr.2023.108390 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Dung, Vu Thi
Dung, Pham Thi Viet
Anh, Hoang Tuan
Nhan, Nguyen Hop
Vu, Nguyen
Nha, Le Kim
Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title_full Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title_fullStr Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title_full_unstemmed Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title_short Anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: A case report
title_sort anterolateral thigh adipofascial flap combined with skin paddle in three-dimension scalp reconstruction: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382746/
https://www.ncbi.nlm.nih.gov/pubmed/37343501
http://dx.doi.org/10.1016/j.ijscr.2023.108390
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