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KMID : 1038220120390020118
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Archives of Plastic Surgery
2012 Volume.39 No. 2 p.118 ~ p.123
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One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique
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Cho Jae-Young
Jang Young-Chul
Hur Gi-Yeun
Koh Jang-Hyu
Seo Dong-Kook
Lee Jong-Wook
Choi Jai-Koo
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Abstract
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Background: An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion.
Methods: From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling.
Results: The mean age of patients was years, with 8 male and 2 female. The size of the burn wound was an average of . The mean expansion duration was days, and the inflation volume was an average of . Mean defect size was . The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision.
Conclusions: Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.
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KEYWORD
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Tissue expansion, Burn, Skull
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