The Pericranial Flap as a Salvage Procedure in Pediatric Neurosurgical Complications

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.

Multi-Directional Galeal Incision for Tensionless Scalp Wound Closure

“…1 Pediatric scalp wound dehiscence is a clinical challenge to be prevented, especially when multiple neurosurgeries are performed via the same incision. 1,2 As the authors reported, covering the skull with a well-vascularized tissue such as a pericranial flap is one of the solutions to prevent pediatric scalp wound complications. Another important factor contributing to wound dehiscence is tension to the wound edge.…”

“…To the Editor: I read with great interest the article entitled “The Pericranial Flap as a Salvage Procedure in Pediatric Neurosurgical Complications” by Karami, et al (J Craniofac Surg. 2021 Jan-Feb 01;32(1):e9-e12) 1 . Pediatric scalp wound dehiscence is a clinical challenge to be prevented, especially when multiple neurosurgeries are performed via the same incision 1,2 .…”

The Use of the Pericranial Periosteal Flap in Children for Treating Severe Lower Eyelid Retraction

“…The use of pericranial flaps in children has been described in craniofacial surgery including the management of meningoencephalocele, 1 cerebrospinal fluid leak management, 2,3 Moyamoya disease, 4 and unilateral lambdoid craniosynostosis. 5 The authors have described the use of pericranial periosteal flaps in adults to reconstruct the posterior lamella of major lower eyelid defects and to achieve significant lower eyelid elevation where severe retraction and poor periocular vascularity exists.…”