Early composite cranioplasty in infants with severe aplasia cutis congenita: a report of two cases.
OBJECTIVE
Severe cutis aplasia congenita has traditionally been treated with initial soft tissue coverage and delayed cranioplasty. We advocate the technique of early composite reconstruction of both bone and soft tissues.


METHODS
Two cases of cutis aplasia congenita with large skull defects (6 x 10 cm, 8 x 8 cm) of superficial layers, skull, and dura are presented. In each case, composite reconstruction was undertaken before 2 weeks of age with restoration of bony and soft tissue coverage through autologous, full-thickness cranial bone grafts and scalp flaps. Both children have been followed up over 2 years with clinical examination and computed tomography (CT) scans.


RESULTS
In both cases, defects were completely repaired postoperatively and remained closed 2 years later. Complete regeneration of calvarial bone graft donor sites were documented by CT scan. Head shape and circumference were normal at 2-year follow up.
Ploplys
Emilia A
EA
Division of Craniofacial and Plastic Surgery, Children's Hospital and Regional Medical Center, Seattle, Washington.
Muzaffar
Arshad R
AR
Gruss
Joseph S
JS
Ellenbogen
Richard G
RG
D016025:Bone Transplantation; D003399:Craniotomy / Q000379:methods*; D004388:Dura Mater / Q000502:physiology; D004476:Ectodermal Dysplasia / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012535:Scalp / Q000601:surgery*; D016038:Skin Transplantation; D012886:Skull / Q000601:surgery*; D013524:Surgical Flaps