title: Two-stage reconstructive surgery of a patient with head trauma resulting in extensive cranial bone and dura mater loss caused by postoperative infection: usefulness of a pericranial flap for dura mater reconstruction.
abstract: After external decompression for a case of head trauma, epidural abscess formation resulted in extensive cranial bone and dura mater loss, for which two-stage reconstructive surgery was conducted. In the first operation, after thorough debridement of the infected wound, the dura mater was reconstructed using a bipedicle pericranial flap with posterior and anterior pedicles. After the infection had completely subsided, the second operation was performed, reconstructing the cranium with grafted outer-table calvarial bone and cutting bone to reposition an old zygomatic fracture. At this point, the pericranial flap used for dura mater reconstruction in the first operation became a satisfactory graft bed for the grafted bone. The postoperative course was satisfactory, and there was no cranial bone absorption after roughly 2 year, and a favorable shape has been maintained for an extremely satisfying result.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Mikako
authors.initials: M
authors.lastname: Takagi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kiyokawa
authors.forename: Aritaka
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Kouichi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Rikimaru
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toru
authors.initials: T
authors.lastname: Shirouzu
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D003646:Debridement; D019299:Decompression, Surgical; D004388:Dura Mater / Q000601:surgery*; D020802:Epidural Abscess / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000601:surgery*; D012887:Skull Fractures / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery*; D015051:Zygomatic Fractures / Q000601:surgery
chemical_list: D008567:Membranes, Artificial