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Chirurgia 2008 February;21(1):49-52

language: English

Cranial bone loss, a valid indication for great omentum vascularized free flap transfer

Lapalorcia L. M. 1, Costa Jr. H. 2, Azevedo L. F. 2, Riobom F. 2, Bistoni G. 1, Chiummariello S. 1, Noviello A. 1, Alfano C. 1, Monteiro Da Costa H. 2

1 Plastic and Reconstructive Surgery Departement University of Perugia, Perugia Italy
2 Plastic and Reconstructive Surgery Department Hospital Santos Silva, Portugal


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Skull bone defects are a possible complication of oncologic neurosurgery followed by radiotherapy, cranial trauma with complicated fractures and infection. Loss of skin, periosteum and galea make the repair difficult and the absence of bone can require osteosynthesis with non autologous material to repair the bone defect (i.e. titanium plates or other synthetic plates of methyl methacrylate). Post operative management of cancer can require radiotherapy that carries the risk of local complications of the surgical wound such as overlying skin necrosis, infections and exposure of the plate. The Authors report on the reconstruction of an infected skull osteocutaneous defect overlying a titanium plate resolved with great omentum microvascular transfer followed by split thickness skin grafting. Omentum flap use remains a valuable option for its immunologic properties of defense, detersion, revascularization and support. It also provides an excellent base for skin grafting allowing epidermic coverage of the wound’s bed.

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