Reconstruction of a large scalp defect using a subcutaneous expander in a patient with the consequences of a cranio-brain injury and combined treatment of a head tumor

Abstract

The features of the treatment of a patient with a traumatic brain injury after radiation therapy were highlighted. It was demonstrated the need for choose a phased treatment for a patient with a combined pathology (cancer skin disease, traumatic brain injury, features of wound healing after a course of radiation therapy). A significant skin defect, radiation damage to the tissues of this area, and the presence of infection did not allow to solve the problem at once, so the method of choice was sequential staged treatment. The importance of the patient’s psycho-emotional state in the treatment process was shown. Since the pre-sence of concomitant pathology, the age of the patient, repeated surgical interventions over a relatively short period of time, infectious complications at the previous stages, led to a depressed psycho-emotional state of the patient, which affected the final result and led the patient to refuse plastic surgery of the skull defect. The authors note the need to involve a psychotherapist in the recovery process to improve the psycho-emotional state of patients with combined pathology and the possibility of conducting the final stage of treatment of the underlying pathology.