Métodos de reconstrução do couro cabeludo

Anbar, Rafael Anache; Almeida, Kleder Gomes de; Nukariya, Paulete Yuri; Anbar, Rodrigo Anache; Coutinho, Bruno Barros de Azevedo

doi:10.1590/s1983-51752012000100026

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…A reconstrução ideal irá depender da avaliação criteriosa de cada caso de acordo com alguns fatores como idade, etiologia, localização, comorbidades, extensão de lesão e a quantidade de planos anatômicos envolvidos 6,7 . A técnica escolhida para a reconstrução deve priorizar o melhor resultado funcional e estético possível, com mínimo de morbidade da área doadora 8 .…”

Section: Introductionunclassified

Reconstrução imediata do couro cabeludo com retalho de transposição baseado na artéria temporal superficial pós-ressecção oncológica

Avila¹,

Lucchese²,

Uliano³

et al. 2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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Os tumores mais comuns envolvendo o couro cabeludo incluem carcinoma basocelular, carcinoma espinocelular e melanoma maligno. A ressecção desses tumores pode causar defeitos variados e complexos. Há vários algoritmos para o tratamento desses defeitos. A reconstrução ideal irá depender da avaliação criteriosa de cada caso de acordo com diversos fatores. A técnica escolhida para a reconstrução deve priorizar o melhor resultado funcional e estético possível, com mínimo de morbidade do sítio doador. Métodos: Relato de caso. Foram revisados o prontuário e os registros fotográficos de um caso de reconstrução imediata com retalho local após ressecção de tumor de couro cabeludo, e realizada revisão bibliográfica. Resultados: Paciente foi submetido à ressecção de tumor de couro cabeludo e à reconstrução imediata com retalho local, com evolução favorável. Conclusão: Existem diversas opções para a reconstrução do escalpo, sendo o retalho local de transposição baseado na artéria temporal superficial, seguida de enxertia da área doadora, uma excelente opção de reconstrução do couro cabeludo.

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Section: Introductionunclassified

Reconstrução imediata do couro cabeludo com retalho de transposição baseado na artéria temporal superficial pós-ressecção oncológica

Avila¹,

Lucchese²,

Uliano³

et al. 2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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The Utility of the Galea in Scalp Reconstruction

Sudduth¹,

Sullivan²,

Walker³

2023

MPS

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Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp's blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.

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