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Handchir Mikrochir Plast Chir 2020; 52(04): 330-334
DOI: 10.1055/a-1150-7601
Fallbericht

Fallbericht einer Frontobasisrekonstruktion und Volumenkorrektur durch freie M. gracilis-Lappenplastik und autologe Fett-Transplantation – Die Lappenplastik als Scaffold für eine Fettgewebe-Transplantation

Case report of frontobasal reconstruction and volume augmentation using a free gracilis muscle flap and autologous fat grafting: utilising the free flap as a scaffold for fat transplantation
Nicholas Möllhoff
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Konstantin Christoph Koban
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Timm Oliver Engelhardt
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Joerg Christian Tonn
2   Neurochirurgische Klinik und Poliklinik, LMU München
,
Riccardo E. Giunta
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
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Zusammenfassung

Dieser Fallbericht zeigt die interdisziplinäre Behandlung einer 28-jährigen Patientin mit ausgeprägtem frontalen Volumendefekt nach schwerem Schädelhirntrauma. Durch die Kombination aus Schädeldachplastik mittels Polymethylmethacrylat (PMMA), freier M. gracilis-Lappenplastik und serieller Eigenfett-Transplantation in das transplantierte Muskelgewebe, konnte der Weichteildefekt ausgeglichen und eine ästhetische Rekonstruktion erzielt werden. Dieses Beispiel unterstreicht die Erweiterung des Behandlungsspektrums an interdisziplinären Exzellenzzentren durch Plastische Chirurgen, wodurch die Versorgung immer komplexerer Knochen-Weichteilläsionen möglich wird.

Abstract

This case report shows the interdisciplinary treatment of a 28-year-old woman suffering from a pronounced frontal volume defect after severe craniocerebral trauma. The combination of cranioplasty using a polymethylmethacrylate (PMMA) implant, free gracilis muscle flap transfer for soft tissue coverage and serial autologous fat grafting into the muscle flap for subsequent contouring enabled both an adequate and aesthetic reconstruction. This example demonstrates the feasibility of treating increasingly complex composite defects in a multidisciplinary setting, when plastic surgeons are involved.

Schlüsselwörter

Stirndefekt - Interdisziplinäre plastische Chirurgie - Mikrochirurgie - Lappenplastik als Scaffold - Autologe Fett-Transplantation

Key words

Forehead defect - interdisciplinary plastic surgery - microsurgery - free flap scaffold - autologous fat grafting


Publication History

Received: 02 February 2020

Accepted: 09 March 2020

Article published online:
21 August 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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