Abstract：
BACKGROUND: The authors reported the first pediatric case of a craniocerebral gunshot injury successfully treated with a wound vacuum-assisted closure (VAC) device after dehiscence and infection of the initial cranial wound.
METHODS: A 17-year-old boy suffered several gunshots to the left hemisphere, resulting in significant damage to the scalp, calvaria, and brain. Emergency hemicraniectomy was performed, with reconstruction of a complicated scalp wound performed at the initial surgery. The scalp was devitalized and ultimately dehisced, resulting in a cranial infection. It was treated first with a repeated attempt at primary closure, which failed because of persistent devitalized tissue, and was then treated with aggressive debridement followed by placement of a wound VAC device over the exposed brain as a bridge therapy to reconstruction. This procedure was deemed necessary given the active infection.
CONCLUSIONS: The patient received delayed reconstruction with a free split-thickness skin graft and made a remarkable recovery, with cranioplasty performed 6 months later. The authors reviewed the literature on wound VAC use in cranial wound treatment and proposed it as a legitimate bridge therapy to definitive reconstruction in the setting of dirty wounds, active infection, or even hemodynamically unstable patients.
METHODS: A 17-year-old boy suffered several gunshots to the left hemisphere, resulting in significant damage to the scalp, calvaria, and brain. Emergency hemicraniectomy was performed, with reconstruction of a complicated scalp wound performed at the initial surgery. The scalp was devitalized and ultimately dehisced, resulting in a cranial infection. It was treated first with a repeated attempt at primary closure, which failed because of persistent devitalized tissue, and was then treated with aggressive debridement followed by placement of a wound VAC device over the exposed brain as a bridge therapy to reconstruction. This procedure was deemed necessary given the active infection.
CONCLUSIONS: The patient received delayed reconstruction with a free split-thickness skin graft and made a remarkable recovery, with cranioplasty performed 6 months later. The authors reviewed the literature on wound VAC use in cranial wound treatment and proposed it as a legitimate bridge therapy to definitive reconstruction in the setting of dirty wounds, active infection, or even hemodynamically unstable patients.
摘要：
背景：作者报道了首例小儿颅脑枪伤病例，在初始颅脑伤口裂开和感染后，成功使用伤口真空辅助闭合（VAC）装置治疗。
方法：一个17岁的男孩左半球遭受了几枪，导致头皮严重损伤，颅骨,和大脑。进行了急诊半切除术，在最初的手术中重建了复杂的头皮伤口。头皮被失活，最终开裂，导致头颅感染.首先进行了一次反复的初次闭合尝试，由于持续的失活组织而失败，然后进行积极清创术，然后在暴露的大脑上放置伤口VAC装置作为重建的桥梁治疗。鉴于活动性感染，该程序被认为是必要的。
结论：患者接受了自由裂层皮肤移植的延迟重建，并取得了显着的恢复，6个月后进行颅骨成形术。作者回顾了有关伤口VAC在颅骨伤口治疗中的使用的文献，并提出了将其作为一种合法的桥梁疗法，可以在肮脏的伤口中进行明确的重建。活动性感染,甚至血流动力学不稳定的患者。
方法：一个17岁的男孩左半球遭受了几枪，导致头皮严重损伤，颅骨,和大脑。进行了急诊半切除术，在最初的手术中重建了复杂的头皮伤口。头皮被失活，最终开裂，导致头颅感染.首先进行了一次反复的初次闭合尝试，由于持续的失活组织而失败，然后进行积极清创术，然后在暴露的大脑上放置伤口VAC装置作为重建的桥梁治疗。鉴于活动性感染，该程序被认为是必要的。
结论：患者接受了自由裂层皮肤移植的延迟重建，并取得了显着的恢复，6个月后进行颅骨成形术。作者回顾了有关伤口VAC在颅骨伤口治疗中的使用的文献，并提出了将其作为一种合法的桥梁疗法，可以在肮脏的伤口中进行明确的重建。活动性感染,甚至血流动力学不稳定的患者。
