RESUMO
Although artificial dura maters such as Gore-Tex are used in cranioplasty, the use of artificial products occasionally results in the formation of infectious lesions. Recently, we encountered two patients who underwent brain surgery and contracted infection from artificial dura maters used for cranioplasty. To treat the postoperative infection, we prepared a vascularized fascia lata attached anterolateral thigh flap that could be applied to the infected wounds in the reconstruction of dura maters and obtained satisfactory results. The present study demonstrated that fascia lata attached anterolateral thigh flaps were useful for reconstructing intractable cranial fistulae complicated by infection. The disadvantages of our surgical technique were the impossibility of simultaneous bone reconstruction and the difficulty in creating a watertight closure of fascia and dura mater, although leakage of cerebrospinal fluid was not observed so far.
Assuntos
Abscesso Encefálico/cirurgia , Craniotomia/efeitos adversos , Dura-Máter/cirurgia , Fascia Lata/transplante , Retalhos Cirúrgicos/irrigação sanguínea , Infecção da Ferida Cirúrgica/cirurgia , Idoso , Abscesso Encefálico/etiologia , Doença Crônica , Fascia Lata/irrigação sanguínea , Feminino , Artéria Femoral/cirurgia , Humanos , Membranas Artificiais , Pessoa de Meia-Idade , Politetrafluoretileno/efeitos adversos , Procedimentos de Cirurgia Plástica , Transplante de Pele/métodos , Infecção da Ferida Cirúrgica/etiologia , Coxa da Perna/cirurgiaRESUMO
Split-thickness skin grafts (STSGs) from the scalp have been used in large burns. The donor site wounds are usually covered using occlusive dressings, such as film dressings because they contribute to reduce donor site pain and infection under exudative crust and to enhance re-epithelialization. However, it is not always easy to fix such film dressings to the scalp because of the presence of hair. In this paper, we report the use of skin staplers to fix the film dressings. Eight donor sites in four patients were dressed in this way. The patients had 50-78% of the body burned, all of them survived. The mean healing time for the donor sites was 6.8 days. Three patients had their scalps re-harvested several times (range two to three times). There were no infections nor secondary skin ulcers at the donor sites. The technique of this dressing is very simple and speedy, thus we recommend the use of skin staplers to fix the film dressing to scalp donor wounds in patients with burns.
