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Case Reports
. 2023 Dec 5;27(2):50.
doi: 10.3892/etm.2023.12339. eCollection 2024 Feb.

Successful repair of an encephalocele wound in a child following a car accident: A case report

Zhiyu Li  1 , Pu Zhao  2 , Xinjun Yang  3 , Cong Fu  3 , Zhen Zhang  4 , Ran Huo  1   3 , Guangqi Xu  1   5
Affiliations
Case Reports

Successful repair of an encephalocele wound in a child following a car accident: A case report

Zhiyu Li et al. Exp Ther Med. .

Abstract

Repair of large cranial complex traumas in children is difficult. Notably, children have poorer underlying conditions than adults and are frailer under trauma. In addition, children have more limited treatment options, leading to the need to consider long-term functional and aesthetic outcomes. The present report describes the case of a 2-year-old child weighing 9 kg who experienced a skull fracture with encephalocele after a car accident and had a poor underlying condition. An artificial dura mater combined with bone cement was used to repair the skull, and then a free latissimus dorsi muscle flap (LDMF) combined with a split-thickness skin graft (STSG) was used to cover the wound, allowing the child to overcome the life-threatening situation as soon as possible with a satisfactory outcome. LDMF combined with STSG is an ideal option in repairing head wounds in children. Preoperative imaging and postoperative care also serve an important role in the success of the operation. When the situation is critical, multidisciplinary team treatment can guarantee the safety of the child.

Keywords: LDMF; STSG; encephalocele; scalp reconstruction; trauma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Preoperative situation. (A) Allograft skin covering the brain tissue. (B) 3D-CTA showing the extent of the scalp defect. (C) 3D-CTA showing the vessels in the auriculotemporal region, with arteries in red and veins in blue. (D) White arrow in the CTA pointing to the severed end of the superficial temporal artery. 3D-CTA, three-dimensional computed tomography angiography; STA, superficial temporal artery.
Figure 2
Figure 2
Intraoperative and postoperative conditions. (A) Removal of allograft skin; (B) brain tissue expanded along the defect; (C) removal of necrotic brain tissue; (D) bone cement shaping; (E) marking the left LDMF; (F) excision of the left LDMF; (G) immediate vascular anastomosis; (H) dressing change on postoperative day 1; (I) darkening of the distal end of the flap on postoperative day 3; (J) sutures removed at 9 days post-surgery; (K) 1 month after surgery; condition of the (L) recipient and (M) donor sites 3 years after surgery. LDMF, latissimus dorsi muscle flap.
Figure 3
Figure 3
Treatment timeline for the patient.
See this image and copyright information in PMC

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