头皮微血管重建通常适用于患有局部晚期肿瘤的患者，以及其他病因学的患者，以及风险相对较高的老年患者群体，这些患者通常患有多种医学合并症。对 2011 年至 2021 年在埃默里大学医院和格雷迪纪念医院接受微血管头皮重建的患者进行回顾性分析。记录患者人口统计数据、伤口特征、手术细节和并发症。使用单变量和多变量模型进行统计分析。研究期间，42 名患者接受了 45 次微血管头皮重建手术。中位年龄为 63 岁。伤口主要是肿瘤性伤口（n = 38，84.4％），并且经常涉及更深的结构[颅骨（n = 38，84.4％），硬脑膜（n = 17，37.8％）]。中位随访时间为 350 天，33 名患者 (73.3%) 皮瓣愈合，9 名患者 (20.0%) 出现伤口愈合问题，但最终成功重建，3 名患者 (6.7%) 皮瓣失败。大多数患者（n=33，80.9%）出院回家或前往康复机构，其余 8 名患者（19.1%）出院至临终关怀中心或死亡。 30天死亡率为4例（8.9%），6个月死亡率为8例（20.5%）。对于> 70岁的患者，单变量分析的30天死亡率（P = 0.0001）和单变量和多变量分析的6个月死亡率（P = 0.003）存在统计学显着差异。虽然年龄 >70 岁是接受微血管头皮重建的患者死亡的危险因素，但死亡率通常与潜在的疾病过程有关，而不是与手术并发症有关。头皮缺损的微血管重建成功率很高，可以作为局部晚期癌症、高龄和多种合并症患者的姑息手术。版权所有 © 2024，医学博士 Mutaz B. Habal。

Microvascular reconstruction of the scalp is frequently indicated in patients with locally advanced tumors, among other etiologies, in a relatively high-risk, older patient population that often has multiple medical comorbidities. A retrospective analysis was performed on patients undergoing microvascular scalp reconstruction at Emory University Hospital and Grady Memorial Hospital between 2011 and 2021. Patient demographics, wound characteristics, operative details, and complications were recorded. Statistical analysis using univariate and multivariate models was performed. Forty-two patients underwent 45 microvascular scalp reconstructive procedures during the study period. The median age was 63 years. Wounds were predominantly oncologic (n=38, 84.4%) and frequently involved deeper structures [calvarium (n=38, 84.4%), dura (n=17, 37.8%)]. At a median follow-up of 350 days, 33 patients (73.3%) had healed flaps, 9 (20.0%) had wound healing issues but ultimately successful reconstruction, and 3 (6.7%) experienced flap failure. Most patients (n=33, 80.9%) were discharged home or to a rehabilitation facility, while the remaining 8 patients (19.1%) were discharged to hospice or died. The 30-day mortality was 4 patients (8.9%) and the 6-month mortality was 8 patients (20.5%). There was a statistically significant difference in 30-day mortality (P=0.0001) on univariate analysis and 6-month mortality (P=0.003) on both univariate and multivariate analysis for patients >70 years. While age >70 years is a risk factor for mortality in patients undergoing microvascular scalp reconstruction, mortality was commonly related to underlying disease processes rather than complication of surgery. Microvascular reconstruction for scalp defects has a high success rate and can be offered as a palliative procedure for patients with locally advanced cancers, advanced age, and multiple comorbidities.Copyright © 2024 by Mutaz B. Habal, MD.