Cranial Defect Overlying a Ventriculoperitoneal Shunt: Pressure Gradient Leading to Free Flap Deterioration?
Archives of Craniofacial Surgery
;
: 186-190, 2017.
Artículo
en Inglés
| WPRIM
| ID: wpr-160332
ABSTRACT
We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pacientes Ambulatorios
/
Cuero Cabelludo
/
Piel
/
Adhesivo de Tejido de Fibrina
/
Estudios de Seguimiento
/
Derivación Ventriculoperitoneal
/
Depresión
/
Craniectomía Descompresiva
/
Colgajos Tisulares Libres
/
Catéteres
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Archives of Craniofacial Surgery
Año:
2017
Tipo del documento:
Artículo
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