Plastic surgery treatment strategy for titanium mesh exposure after titanium mesh for repair of skull defects
QUAN Xin
GENG Jian
DONG Liwei
TANG Yinke
TAN Chen
DU Yichen
XIA Wensen
MA Xianjie
Abstract：Objective To investigate the treatment strategy selection and corresponding curative effect analysis of titanium mesh exposure after titanium mesh for repair of skull defects in patients with skull defects such as craniocerebral trauma or tumor.Methods The clinical data of 65 patients with titanium mesh exposure after titanium mesh for repair of skull defects admitted to the Department of Plastic Surgery,Xijing Hospital,Air Force Medical University from March 2011 to October 2023 were retrospectively analyzed.According to the degree of infection of the exposed wound,the duration of exposure,the size of the exposed area,the local secretion and culture,and the risk factors of the patient,the individual decision was made whether to retain or remove the titanium mesh.If there was obvious large-scale exposure and infection in peripheral areas,the titanium mesh was removed and the infected lesion was cleared.After covering the wound,the skull repair was performed again in the second stage.The wound healing in the exposed area of titanium mesh after operation was taken as the curative effect index.The patients were followed up for wound healing,appearance repair and quality of life at 1,3,6 and 12 months after discharge.Results Of the 65 patients,53(81.5％)had implant exposure accompanied by significant infection.Six patients with local infection of titanium mesh repair were finally cured by non-surgical treatment,and 59 patients underwent surgical treatment.Among the surgical patients,12 patients successfully preserved the titanium mesh through the local rotation head flap.In 47 cases,titanium mesh was removed and skin flap was used to cover the defect wound.Among them,11 cases were followed up for 12 months after operation,and titanium mesh was used to repair skull defects again.All patients had good wound healing and no effect on quality of life.Conclusion The exposure of titanium mesh after titanium mesh for repair of skull defects is often accompanied by infection.Thorough debridement and dressing change is the basis of healing.Patients with only minor wound infection can consider non-surgical treatment with titanium mesh retention.For patients with a small area of infection in the exposed area,the local flap can be transferred to cover the wound after thorough debridement to retain the original titanium mesh,or the local titanium mesh can be cut off to retain most of the titanium mesh.For obvious large-scale exposure and severe infection,it is necessary to completely remove the titanium mesh and cover the wound with the flap,and the skull defects can be repaired again in the long term.After individualized treatment,the patient's wound heals well and does not affect the quality of life.
Keywords：skull defectspostoperative complicationsskull titanium mesh repairtitanium mesh exposureflap transfer
Publication Date：2024-08-28
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：4( 891-894 )