Reconstruction of a large scalp defect using a subcutaneous expander in a patient with the consequences of a cranio-brain injury and combined treatment of a head tumor

M. Tonchev, A. O. Nos
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Abstract

The features of the treatment of a patient with a traumatic brain injury after radiation therapy were highlighted. It was demonstrated the need for choose a phased treatment for a patient with a combined pathology (cancer skin disease, traumatic brain injury, features of wound healing after a course of radiation therapy). A significant skin defect, radiation damage to the tissues of this area, and the presence of infection did not allow to solve the problem at once, so the method of choice was sequential staged treatment. The importance of the patient’s psycho-emotional state in the treatment process was shown. Since the pre-sence of concomitant pathology, the age of the patient, repeated surgical interventions over a relatively short period of time, infectious complications at the previous stages, led to a depressed psycho-emotional state of the patient, which affected the final result and led the patient to refuse plastic surgery of the skull defect. The authors note the need to involve a psychotherapist in the recovery process to improve the psycho-emotional state of patients with combined pathology and the possibility of conducting the final stage of treatment of the underlying pathology.
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应用皮下扩张器重建颅脑损伤及头部肿瘤联合治疗的大面积头皮缺损
本文报道了一例创伤性脑损伤放射治疗后的治疗特点。结果表明,对于合并病理(癌症皮肤病、创伤性脑损伤、放射治疗后伤口愈合的特征)的患者,需要选择分阶段治疗。明显的皮肤缺损,对该区域组织的辐射损伤,以及感染的存在不允许立即解决问题,因此选择的方法是顺序分阶段治疗。显示了患者心理情绪状态在治疗过程中的重要性。由于合并病理的存在、患者的年龄、较短时间内多次手术干预、前期感染并发症等原因,导致患者心理情绪状态低落,影响最终结果,导致患者拒绝颅骨缺损整形手术。作者指出,在康复过程中需要心理治疗师的参与,以改善合并病理患者的心理情绪状态,并有可能对潜在病理进行最后阶段的治疗。
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