Staged reconstruction of a chronically infected large skull defect using free tissue transfer and a patientspecific polyetheretherketone implant

• Published in: Archives of craniofacial surgery 2020, 21(5), , pp.309-314
• Main Authors: 문승진, 전홍배, 김의현, 류대현, 김용욱, 홍종원
• Format: Article
• Language: English
• Subjects: 성형외과학
• ISSN: 2287-1152; 2287-5603
• DOI: 10.7181/acfs.2020.00311

Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period. KCI Citation Count: 0