作者： Pang‐Yun Chou MD Cheng‐Hung Lin MD Chung‐Chen Hsu MD Wei‐Hsun Yang MD Alex A. Kane MD Chih‐Hung Lin MD
文章出處： Head Neck. 2017 Aug;39(8):1655-1661
摘要：
一、背景:
顱骨成形術後鑲嵌式植入物暴露令人沮喪。這項研究的目的是讓作者介紹自由組織皮瓣轉移的經驗，以挽救顱骨成形術後植入物暴露的機率。
二、方法:
對2004年1月至2016年2月顱骨成形術後暴露種植體覆蓋的所有執行自由組織皮瓣轉移術患者進行回顧性醫學圖表審查。
三、結果:
對11例接受顱骨成形術且植入物暴露的患者進行了12次游離皮瓣手術，而這11名患者曾接受過局部皮瓣覆蓋植入的鈦板結果失敗。游離皮瓣手術所用的游離皮瓣包括股前外側皮瓣，前臂橈側皮瓣，大腿前內側和股直肌嵌合皮瓣，背闊肌皮瓣，股薄肌皮瓣和顳頂皮瓣。皮瓣存活率為100％，11個植入的鈦板中的10個（91％）成功保留。
結論為自由組織轉移應被視為顱骨成形術後暴露種植體挽救的重建選擇。即使長期植入物暴露（> 3個月），也可以獲得高植入體保留率（> 90％）。
Abstract
BACKGROUND:
Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure.
METHODS:
A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016.
RESULTS:
Twelve free flaps were performed in 11 patients who underwent postcranioplasty with implant exposure, and whose attempted implant coverage using locoregional flaps had failed. The free flaps used included anterolateral thigh flap, radial forearm flap, anteromedial thigh and rectus femoris chimeric flap, latissimus dorsi flap, gracilis flap, and Juri flap. The flap survival rate was 100%, and 10 of 11 implants (91%) were salvaged without removal.
CONCLUSIONS:
Free tissue transfer should be considered as the preferred reconstructive option for postcranioplasty exposed implant salvage. High rate of implant salvage (>90%) is possible even with chronic implant exposure (>3 months).
© 2017 Wiley Periodicals, Inc.
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