#scalpreconstruction

[drmuya]

Scalp Reconstruction In Exposed Infected Titanium Mesh . . 2 weeks ago, I had a referral for a soft tissue coverage of an infected exposed titanium mesh. The mesh has been there for almost 10 years, but unfortunately it got infected and exposed within 2 weeks before she presented to us. . . Together with neurosurgery team, the infected titanium mesh is removed, part of the superficial part of the dura that is non viable is also debrided, leaving a partially calcified dura underneath. Despite after titanium mesh removal, the wound is still large to be closed primarily. Thats when plastic surgery input is needed in such cases. . . After an intra operative assessment, I decided to extend my incisions using the same scar, and advanced the forehead skin (free forehead lift 😉, rotate the contralateral scalp, and also rotate the ipsilateral scalp. Thankfully, all 3 advancement and rotations managed to close the exposed dura, and donor area still can be closed primarily. . . Because the wound closure has a little bit of tension in its approximation, a splinting negative pressure wound therapy was applied on the wound to facilitate the healing and the approximation. . . It was not a straightforward case for me, as the patient’s previous incision for her initial craniotomy surgery severed blood supplies from right superficial temporal artery and also supplies from frontal (supratrocheal/supraorbital arteries). Therefore, the planning for a local flap is limited because I could not burn any further bridges for blood supply, that I may need for future tissue expansion insertion when a new titanium mesh will be inserted. My lifeboat is a split thickness skin graft (simplest but it is certainly not the most ideal type of soft tissue coverage for cranial protection, and it can be quite a hassle to elevate a grafted skin from the dura underneath in future procedure). Fortunately, it was not needed this time . . ________________________________________ #RestoreandRefine™🦋 . . #plasticsurgery #plasticandreconstructivesurgery #reconstructivesurgery #plasticsurgeon #plasticsurgerymalaysia #femalesurgeon #ladysurgeon #scalpreconstruction #headandneck #infectedtitaniummesh https://www.instagram.com/p/CCQwOPUlQET/?igshid=ip2vtz7dnpkq

[savasserel]

#scalpreconstruction with the bone defect by #altflap #microsurgery #plasticsurgery #futureofscience #perforatorflap #teamwork #neurosurgery #ankara #turkey #ankarauniversity #drserel (Ankara Ünv.Tıp Fakültesi Cebeci Hastanesi Başhekimlik)

[myparthadental]

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