Surgical treatment of a newborn child with congenital aplasia of the scalp

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Introduction. Skin aplasia is a developmental defect represented by a skin defect of varying extent, often in combination with the defect of underlying tissues – subcutaneous fat, muscles and with various forms of dysraphy - non-closured embryonic slits. By various authors, defect frequency ranges from 1 per 1 000 to 1 per 10 000 newborns. Congenital focal aplasia of the skin and subcutaneous tissues can be located in limited areas; most often it is diagnosed on the scalp looking like single or multiple focal skin defects. Quite often, focal aplasia also affects the skin on the trunk and limbs.

Description of observation. The article presents a clinical case of congenital focal aplasia of the scalp and skull bones in a newborn child. This type of skin congenital aplasia by I. Frieden classification corresponds to Group I of congenital aplasia of the skin with lesions on the scalp. At the expert examination with multispiral computed tomography, the absence of parietal bone was diagnosed. So, the defect bottom was dura mater. In this case, the authors considered conservative approach to be unacceptable because of long period of healing and high risk of secondary infection. The performed surgery has led to a satisfactory cosmetic result. The state of bone structures was assessed catamnetically.

Conclusion. Modern diagnostic techniques have proven that an active surgical tactics in children with congenital aplasia of the scalp is justified.

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作者简介

Ksenya Bardeeva

Omsk State Medical University; Children’s Regional Clinical hospital, Omsk

编辑信件的主要联系方式.
Email: bardeeva@list.ru
ORCID iD: 0000-0002-5871-751X

associate professor, department of pediatric surgery, Omsk State Medical University

俄罗斯联邦, 644099 Omsk; 644001 Omsk

V. Mishkin

Children’s Regional Clinical hospital, Omsk

Email: cool.68@mail.ru
ORCID iD: 0000-0002-5034-3357
俄罗斯联邦, 644001 Omsk

A. Pisklakov

Omsk State Medical University; Children’s Regional Clinical hospital, Omsk

Email: pisklakovomsk@mail.ru
ORCID iD: 0000-0001-7594-7723
俄罗斯联邦, 644099 Omsk, Russian Federation; 644001 Omsk

V. Ponomarev

Omsk State Medical University; Children’s Regional Clinical hospital, Omsk

Email: pvikust@yandex.ru
ORCID iD: 0000-0002-2555-7994
俄罗斯联邦, 644099 Omsk, Russian Federation; 644001 Omsk

N. Pavlenko

Omsk State Medical University; Children’s Regional Clinical hospital, Omsk

Email: nipavlenko@mail.ru
ORCID iD: 0000-0001-6242-6195
俄罗斯联邦, 644099 Omsk, Russian Federation; 644001 Omsk

参考

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2. Fig. 1. Patient’s appearance. A soft tissue defect on the scalp is visualized.

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3. Fig. 2. MSCT in 3D bone reconstruction mode. Wide-open sutures, local areas of thinning of the frontal bone are visible.

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4. Fig. 3. Surgical wound view. The defect on the scalp is 3 × 4 cm.

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5. Fig. 4. View of the postoperative wound.

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6. Fig. 5. Craniography in the direct projection. There is no any bone-traumatic, destructive pathology.

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版权所有 © Bardeeva K.A., Mishkin V.V., Pisklakov A.V., Ponomarev V.I., Pavlenko N.I., 2023

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