Couverture d’une exposition cérébrale post-traumatique par un lambeau temporal total : à propos d’un cas

Abstract

Major defect of the scalp associated with penetrating brain injury is one of the most challenging issues in acute craniofacial trauma. Depressed skull fractures associated with injuries of the skin and periosteal tissue can be easily covered using various locoregional scalp flap techniques. However, if the skin is damaged around the wound, the surgical possibilities are reduced, allowing only local transposition flap or free flap coverage with many disadvantages for the latter such as vascular micro-anastomosis issues, unsuitable underlying vascular status, and a “patch” effect which is often unsightly. The authors describe, using a clinical case, the steps to provide a total temporal flap to cover a defect of both skin and bone. This can be performed in three separated stages: the first is the empowerment of both middle temporal pedicles; the second stage, 15 days later, is the section, transposition and coverage of the wound; the third stage, 30 days later, is the flap separation.