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- Title
Staged reconstruction of a chronically infected large skull defect using free tissue transfer and a patientspecific polyetheretherketone implant.
- Authors
Seung Jin Moon; Hong Bae Jeon; Eui Hyun Kim; Dae Hyun Lew; Yong Oock Kim; Jong Won Hong
- Abstract
Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period.
- Subjects
TREATMENT of skull abnormalities; POLYETHER ether ketone; SKULL surgery
- Publication
Archives of Craniofacial Surgery, 2020, Vol 21, Issue 5, p309
- ISSN
2287-1152
- Publication type
Article
- DOI
10.7181/acfs.2020.00311