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本组6例,男4例,女2例。年龄3～8岁。伤后病程42d至5个月。其中车祸4例,电击伤1例,烧伤后感染1例。创面骨裸露之横径均大于5cm,最小面积6cm×11cm,最大面积8cm×12cm。术中清创后凿去外露之骨外权至出血后,用1％新洁尔灭湿敷10min,选创周局部头皮瓣覆盖骨外露创面。供瓣区植刃厚皮,同时在供瓣区周围选埋合适的扩张器。注水3～4周,Ⅱ期手术时用“剩余”皮肤修复植皮区,术后皮瓣全部成活,毛发生长好,外观满意(图1、2、3)。随访6个月至1年,未见有儿童颅骨发育障碍出现。 讨论 以往修复颅骨外露创面常用骨组织肉芽上植皮,骨膜瓣上植皮,游离皮瓣转移等都有一定的优缺点。如需
The group of 6 patients, 4 males and 2 females. Age 3 to 8 years old. The duration of injury 42d to 5 months. Including 4 cases of car accident, electric shock in 1 case, 1 case of burn infection. The diameter of the wound exposed bone are greater than 5cm, the minimum area of 6cm × 11cm, the maximum area of 8cm × 12cm. After debridement surgery to expose the bone outside the right to hemorrhage after bleeding with 1% benzalkonium bromide wet compress 10min, choose the Department of Zhou partial scalp flap covered with bone exposed wounds. Flap for the flap blade thickness, at the same time in the area around the valve for the election buried suitable dilator. Infusion 3 to 4 weeks, Ⅱ period of surgery with “surplus” skin repair skin graft area, the flap alive after all, good hair growth, the appearance of satisfaction (Figure 1,2,3). Follow-up of 6 months to 1 year, no children with cranial development appeared. Discuss the past repair skull exposed wound commonly used in bone grafting granulation, periosteal flap grafting, free flap transfer and so on have some advantages and disadvantages. If needed