文章基本信息

标题：Salvage of an exposed cranial prosthetic implant using a transposition flap with an indwelling antibiotic irrigation system
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作者：Sung Oh Hwang ; Lan Sook Chang
期刊名称：Archives of Craniofacial Surgery
印刷版ISSN：2287-1152
出版年度：2020
卷号：21
期号：1
页码：73-76
DOI：10.7181/acfs.2019.00647
出版社：KoreaMed Synapse
摘要：Cranial implant removal is recommended if implants become exposed owing to scalp necrosis after cranioplasty. However, it carries the risk of extensive bleeding, and the resultant cranial defects can cause both aesthetic and functional problems. We present a case of a scalp defect exposing a cranial prosthetic implant that was reconstructed with a local flap and salvaged using an indwelling antibiotic irrigation system. A 73-year-old man presented with scalp necrosis after undergoing cranioplasty due to intracranial hemorrhage. The cranial implant was exposed through the scalp defect. Methicillin-resistant Staphylococcus aureus was detected in the culture from the open wound. After debridement of the necrotic tissue and burring of the superficial layer of the implant, a transposition flap was used to cover the defect and an indwelling antibiotic irrigation system was installed. Continuous irrigation with vancomycin was conducted for 5 days, and intravenous vancomycin was continued for 4 weeks. The flap was in good condition at 4 months postoperatively, with no infection. The convex contour of the scalp was well maintained. The patient's neurological status was stable. Exposed cranial implants can be salvaged with continuous antibiotic irrigation as an alternative to implant removal; thus, the risk of bleeding and possible disfigurement may be avoided.
关键词：Indwelling catheter;Prosthetic and implants;Salvage treatment;Therapeutic irrigations