TISSUE EXPANSION IN NEUROSURGICAL RECONSTRUCTIVE TECHNIQUE - CASE-REPORT

BACKGROUND Various reconstructive techniques using hair-bearing scalp to manage unsightly scalp defects have been described. In 1983, Fonsec a and in 1984, Horowitz emphasized the use of galeal-pericranial flaps in scalp wounds with exposed bone. In 1986, Matthews and Missoten des cribed early tissue expansion to close a traumatic defect of the scalp , and in 1990 Kiyono placed tissue expander in a pocket adjacent to th e defect that was covered with Marlex Mesh. METHODS The authors presen t a case of 23-year-old man with a scalp laceration over a depressed f racture of the skull and a dural tear, after a traffic accident. The r epair procedures at another hospital failed, resulting in an area of s calp necrosis with a cerebrospinal fluid (CSF) leak. At our observatio n, the reconstructive technique using hair-bearing scalp with tissue e xpander was performed to manage unsightly scalp necrosis. Moreover the neurosurgical treatment was necessary to avoid the complications of t he CSF leak. CONCLUSIONS A 9-year review showed more than 40 patients treated by this technique that allows a pericranial flap of every size . When scalp defects are too large, the tissue expander allows good ae sthetic results.