Composite skull and dura defect reconstruction using combined latissimus dorsi musculocutaneous and serratus anterior muscle-rib free flap coupled with vascularized galea transfer: a case report.
Recalcitrant epidural abscess following cranioplasty is a complicated problem, which becomes even more trying when large span of dura and skull bone are being replaced by alloplastic materials. A 22-year-old male underwent right fronto-temporo-parietal craniectomy and duroplasty with artificial dura graft after traumatic brain injury. Epidural abscesses recurred after cranioplasty with autologous bone graft as well as with a methyl methacrylate bone plate. The massive defects of both the dura and skull bone (15 × 9 cm) caused by radical debridement were reconstructed successfully with a combined free latissimus dorsi and serratus anterior myo-osseous flap transfer plus galea flap transposition. Proper contour and adequate stability of the construct were maintained during 2-year follow up without episodes of relapsing infection.
Lee
Jing-Wei
JW
Section of Plastic Surgery, National Cheng-Kung University College of Medicine and Hospital, Tainan, Taiwan.
Hsueh
Yuan-Yu
YY
Lee
Jung-Shun
JS
D001860:Bone Plates; D001930:Brain Injuries / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000601:surgery; D003646:Debridement; D056424:Decompressive Craniectomy; D004388:Dura Mater / Q000601:surgery; D020802:Epidural Abscess / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012535:Scalp / Q000601:surgery; D012887:Skull Fractures / Q000601:surgery*; D055815:Young Adult