Regraft from Amputated Forehead Tissue of a 4×7 cm Skin Defect Containing Bony Defects

ImageS region containing bony defects of approximately 2×3 cm using a regraft from amputated soft tissue of the forehead. Thus, we obtained a good treatment outcome without using previously reported treatment methods such as a tie-over dressing although vascular anastomosis could not be performed in our case. Here, we report on our treatment outcomes. In July 2009, a 52-year-old woman visited an emergency room with a chief complaint of a soft tissue defect of 4×7 cm containing bony defects approximately 2×3 cm in size extending over the forehead and scalp because the patient sustained an injury from a deadly metal weapon by her husband (Fig. 1A). The injury resulted in the amputation of soft tissue of the forehead and scalp. At the time of the emergency room visit, the patient also presented with a small bowel perforation due to a stab injury in the abdomen. After undergoing an emergency laparotomy in the Department of Surgery for approximately 3 hours and receiving treatment at an intensive care unit, the patient was referred to us for further evaluation and treatment. At the time of referral to us, the patient had not presented with the amputated tissue. Therefore, following conservative treatment, it was decided that a skin graft or flap surgery would be performed once granulation tissue had formed. During the monitoring of the clinical course, the patient’s caregiver found the amputated soft tissue of the forehead region, approximately 7 hours after the injury at the location where the patient sustained the injury (Fig. 2). We had attempted to perform a microvascular anastomosis, but we could not because the anesthesiologist judged that the patient could not undergo general anesthesia again. However, if treatment were further delayed, the patient would have been at risk of increased damage. Therefore, we performed the regraft of the amputated Regraft from Amputated Forehead Tissue of a 4×7 cm Skin Defect Containing Bony Defects