Skalp Defektlerinin Serbest Flepler ile Rekonstrüksiyonu

Ersin Gur; Turgut Furkan Kuybulu; Hamit Hakan Bekir; Nargiz İbrahimli; Mehmet Emre Yeğin; Gizem Şule Ateş; Yiğit Özer Tiftikcioğlu

doi:10.19161/etd.1215279

TR EN

Skalp Defektlerinin Serbest Flepler ile Rekonstrüksiyonu

Öz

Amaç: Skalp; kalvaryal kemiklerin üzerini örtmesi ve saç içermesi gibi önemli görevlere sahiptir. Fonksiyonel ve estetik önemi nedeniyle skalp rekonstrüksiyonu plastik cerrahların sıklıkla ilgilendiği özel bir konu haline gelmiştir. Serbest flepler skalp rekonstrüksiyonu için uzun zamandır güvenli bir şekilde kullanılmasına rağmen ideal flep konusunda literatürde bir fikir birliğine ulaşılamamıştır. Çalışmamızda skalp rekonstrüksiyonlarındaki serbest flep tecrübelerimizi sunmayı amaçladık. Gereç ve Yöntem: 2018-2021 yılları arasında toplam 7 hastada (3 kadın, 4 erkek ) 8 serbest flep ile skalp rekonstrüksiyonu uygulandı. Hastaların yaşları 8 – 73 arasındaydı. Serbest flep tercihlerimiz arasında 4 latissimus dorsi flebi, 3 anterolateral uyluk flebi ve 1 vertikal rektus abdominis muskulokutan flebi yer almaktaydı. Alıcı damar olarak olarak temporalis süperfisiyalis, temporalis süperfisiyalisin frontal dalı, oksipital damarlar, fasiyal damarlar ve trapezius kasının uygun çapta perforatörü kullanıldı. Bulgular: Latissimus dorsi serbest flebi yapılan 1 hastada venöz tromboz görüldü. Tüm girişimlere rağmen flep kurtarılamadı. Komplikasyon olarak 1 hastada donör alanda seroma ve 1 hastada alıcı alanda dehisans görüldü. Ek komplikasyon veya flep kaybı gözlenmedi. Sonuç: Serbest flepler geniş ve/veya kompozit skalp defektlerinde kullanışlı seçeneklerdir. Teknik zorluklarına rağmen, perforatör fleplerin avantajlarından dolayı skalp rekonstrüksiyonunda ilk tercih olabileceğini düşünmekteyiz. Latissimus dorsi flebi, ilk flebin başarısızlığı durumunda kurtarıcı bir alternatif olarak kullanılabilir. Not: Çalışmamız 18-21 Mayıs 2022 tarihinde Bodrum, Muğla’da gerçekleştirilen 9. Ulusal Rekonstrüktif Mikrocerrahi ve 2. Ulusal Acil El Cerrahisi ve Mikrocerrahi Kongresinde sözlü bildiri olarak sunulmuştur.

Anahtar Kelimeler

Reconstruction of Scalp Defects with Free Flaps

Abstract

Aim: The scalp has important roles such as containing hair folicles and covering calvarial bones. Due to both aesthetic and functional importance, reconstruction of the scalp becomes special topic that plastic surgeons are frequently interested in. Although free flaps have been used safely in scalp reconstruction for a long time, there is no consensus in the literature on the ideal flap. We aimed to present our free flap experience in scalp defects. Materials and Methods: Between 2018 and 2021, 8 free flaps were used for scalp reconstruction in 7 patients (3 female, 4 male). The ages of the patients ranged from 8 to 73. The flap choices included 4 latissimus dorsi free flaps, 3 anterolateral thigh flaps and 1 vertical rectus abdominis musculocutaneous flap. Temporalis superficialis, frontal branch of temporalis superficialis, occipital, facial vessels and a perforator of the appropriate diameter of the trapezius muscle were used as recipient. Results: Venous thrombosis was seen in 1 latissimus dorsi flap. Despite of all attempts the flap could not be salvaged. 1 Seroma and 1 wound dehiscence occurred in different patients as complication. No additional complications or flap loss were experienced. Conclusion: Free flaps are useful options for large and/or composite defects of the scalp. Despite of technical difficulty, we think that the perforator flaps can be a first choice for scalp reconstructions due to their advantages. So, the latissimus dorsi flap can be used as a second life-boat alternative in the possibility of the flap failure of the first flap.

Keywords

References

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Ersin Gur ^*
0000-0003-4776-1934
Türkiye

Turgut Furkan Kuybulu
0000-0003-4309-6420
Türkiye

Hamit Hakan Bekir
0000-0002-2331-6548
Türkiye

Nargiz İbrahimli
0000-0002-0767-8717
Türkiye

Mehmet Emre Yeğin
0000-0001-5788-0705
Türkiye

Gizem Şule Ateş
0000-0001-6445-1669
Türkiye

Yiğit Özer Tiftikcioğlu
0000-0002-9930-5802
Türkiye

Publication Date

December 18, 2023

Submission Date

December 6, 2022

Acceptance Date

December 15, 2023

Published in Issue

Year 2023 Volume: 62 Number: 4

DOI

https://doi.org/10.19161/etd.1215279

IZ

https://izlik.org/JA42XG76PF

Cite

RIS / Bibtex

Vancouver

1.Ersin Gur, Turgut Furkan Kuybulu, Hamit Hakan Bekir, Nargiz İbrahimli, Mehmet Emre Yeğin, Gizem Şule Ateş, Yiğit Özer Tiftikcioğlu. Skalp Defektlerinin Serbest Flepler ile Rekonstrüksiyonu. EJM. 2023 Dec. 1;62(4):515-21. doi:10.19161/etd.1215279