PDF(Pubmed)
Abstract：
BACKGROUND: This report describes the use of a novel approach to address acute sinking skin flap syndrome (SSFS), a postcraniectomy complication arising from brain dysfunction beneath the skull defect. The authors present a case series of two patients, emphasizing the prospective application of an external plaster cast in tandem with a vacuum-assisted closure (VAC) device (wound VAC) to promptly reposition the scalp and relieve brain compression.
METHODS: Following intervention, one patient showed immediate neurological improvement, with complete resolution of symptoms within hours. Conversely, the second patient developed nonconvulsive status epilepticus. Computed tomography scans postintervention validated the successful scalp repositioning and mass effect resolution in both instances. This temporary approach proved successful in one patient with moderate symptoms, serving as a bridge to cranioplasty.
CONCLUSIONS: The integration of an external plaster cast and wound VAC offers a cost-effective and prompt solution for patients with acute SSFS pending cranioplasty. Appropriate patient selection and heightened caution for those with severe symptoms should be exercised.
METHODS: Following intervention, one patient showed immediate neurological improvement, with complete resolution of symptoms within hours. Conversely, the second patient developed nonconvulsive status epilepticus. Computed tomography scans postintervention validated the successful scalp repositioning and mass effect resolution in both instances. This temporary approach proved successful in one patient with moderate symptoms, serving as a bridge to cranioplasty.
CONCLUSIONS: The integration of an external plaster cast and wound VAC offers a cost-effective and prompt solution for patients with acute SSFS pending cranioplasty. Appropriate patient selection and heightened caution for those with severe symptoms should be exercised.
摘要：
背景：本报告描述了一种新的方法来解决急性皮瓣下沉综合征（SSFS），颅骨缺损下的脑功能障碍引起的开颅术后并发症。作者介绍了两个患者的病例系列，强调与真空辅助闭合（VAC）装置（伤口VAC）串联的外部石膏模型的预期应用，以迅速重新定位头皮并减轻大脑压迫。
方法：干预后，一名患者表现出立即的神经系统改善，症状在数小时内完全缓解。相反，第二名患者出现非惊厥性癫痫持续状态.介入后的计算机断层扫描扫描验证了两种情况下成功的头皮重新定位和质量效应分辨率。这种临时方法在一名中度症状的患者中被证明是成功的，作为颅骨修补术的桥梁。
结论：外部石膏模型和伤口VAC的整合为正在进行颅骨成形术的急性SSFS患者提供了一种经济有效且及时的解决方案。应适当选择患者，并对症状严重的患者应格外小心。
方法：干预后，一名患者表现出立即的神经系统改善，症状在数小时内完全缓解。相反，第二名患者出现非惊厥性癫痫持续状态.介入后的计算机断层扫描扫描验证了两种情况下成功的头皮重新定位和质量效应分辨率。这种临时方法在一名中度症状的患者中被证明是成功的，作为颅骨修补术的桥梁。
结论：外部石膏模型和伤口VAC的整合为正在进行颅骨成形术的急性SSFS患者提供了一种经济有效且及时的解决方案。应适当选择患者，并对症状严重的患者应格外小心。
