Cranial Defect Overlying a Ventriculoperitoneal Shunt: Pressure Gradient Leading to Free Flap Deterioration?Cranial Defect Overlying a Ventriculoperitoneal Shunt: Pressure Gradient Leading to Free Flap Deterioration?
- Other Titles
- Cranial Defect Overlying a Ventriculoperitoneal Shunt: Pressure Gradient Leading to Free Flap Deterioration?
- Authors
- 주재두; 장진욱; 김현석; 윤을식; 강동희
- Issue Date
- 2017
- Publisher
- 대한두개안면성형외과학회
- Keywords
- Decompressive craniectomy; Free tissue flaps; Ventriculoperitoneal shunt
- Citation
- Archives of Craniofacial Surgery, v.18, no.3, pp.186 - 190
- Indexed
- KCI
OTHER
- Journal Title
- Archives of Craniofacial Surgery
- Volume
- 18
- Number
- 3
- Start Page
- 186
- End Page
- 190
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/85333
- ISSN
- 2287-1152
- Abstract
- We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt).
The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus.
Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months’ outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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