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The Pericranial Flap as a Salvage Procedure in Pediatric Neurosurgical Complications
Reem A Karami1, Georgio M Atallah, Odette Abou Ghanem
1Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Insights
The pericranial flap is a safe and effective option for pediatric scalp and skull reconstruction. This vascularized tissue showed no major complications in a 10-patient study, highlighting its utility.
Area of Science:
- Craniofacial surgery
- Pediatric reconstructive surgery
- Plastic surgery
Background:
- The pericranium, a vascularized tissue layer, is valuable for complex scalp and skull defect repair.
- It serves as a prophylactic measure against wound complications in high-risk pediatric patients.
Purpose of the Study:
- To evaluate the efficacy and safety of the pericranial flap in pediatric patients.
- To assess its use in both prophylactic applications and treatment of chronic draining sinuses.
Main Methods:
- Retrospective chart review of pediatric patients undergoing pericranial flap procedures.
- Study conducted at the American University of Beirut Medical Center between February 2010 and 2020.
- Inclusion criteria: pediatric patients requiring prophylactic flap or treatment for chronic draining sinus.
Main Results:
- Ten pediatric patients were included (3 prophylactic, 7 chronic draining sinus).
- Average follow-up was 23 days with no reported infections, hematoma, seroma, or meningitis.
- One case of superficial skin dehiscence occurred, managed conservatively with healing within two weeks.
Conclusions:
- The pericranial flap is a reliable "workhorse" flap for pediatric scalp and skull reconstruction.
- It offers excellent outcomes with minimal donor site morbidity.
- Consideration of the pericranial flap is recommended for appropriate pediatric cases.
Abstract:
The pericranium is a vascularized structure that can be used for the treatment of complex scalp and skull defects. It is also utilized as a prophylactic measure to prevent wound complications in high-risk patients. In this study, we looked at the use of the pericranial flap in pediatric patients. A retrospective chart review was done in the American University of Beirut Medical Center from February 2010 to 2020. Ten pediatric patients were identified who required either prophylactic pericranial flap (n = 3) or for treatment of a chronic draining sinus (n = 7). Patients were followed up for an average of 23 days. There were no cases of infection, hematoma, seroma, or meningitis. Only 1 case developed dehiscence of the skin. It was managed conservatively and healed within 2 weeks. The pericranial flap is a workhorse flap for scalp and skull reconstruction, with no donor site morbidity and thus should always be considered.
