Salvage of Methylmethacrylate Cranioplasty with Advancement Scalp Flap and Hyperbaric Oxygen Therapy-A Case Report

Abstract

Background: The use of methylmethacrylate for cranioplasty is a common operation. It is possible to cause serious complications, such as scalp necrosis and methylmethacrylate plate exposure. If the complication occurred, reconstruction of the wound was necessary. Aim and Objectives: Using flaps to cover the wound with whole-layered scalp defect and methylmethacrylate exposure is necessary. The best replacement for scalp tissue is scalp tissue itself. Materials and Methods: The patient received cranioplasty because of skull defect and contour deformity. After the operation, a 10×6 cm, whole-layeres scalp necrosis and methylmethacrylate exposure was noted. The wound was successfully closed by scalp advancement flap with galeal scoring. After closing the defect, ischemia of the previous free flap aside the wound was noted. Hyperbaric oxygen therapy was applied to salvage the flap. Result: We successfully reconstructed the defect by one-staged scalp advancement flap. Besides, the ischemic flap was salvaged by HBO therapy. Conclusion: By scalp advancement flap and galeal scoring, moderate sized scalp defect can be closed directly. The cosmetic result is acceptable.