Preparating Scalp Arteries for Childhood Moyamoya Disease Surgery using Subcutaneous Injections of Physiological Saline(SURGICAL TECHNIQUES and PERIOPERATIVE MANAGEMENT)

Abstract

Skin necrosis sometimes occurs along a scalp artery prepared for the treatment of childhood moyamoya disease. In the present study, the subcutaneous injection of physiological saline along the scalp artery was introduced to prevent the necrosis. From January 7, 2007 to October 20, 2007, twenty-two children with moyamoya disease were operated on 29 times in total. About 10 ml of physiological saline was injected along the scalp artery in the skin flap to elevate it from the outer layer of the skin before preparing in for transplant, in the all patients except a 7-year-old girl whose skin was relatively thick. There was no necrosis in the skin flaps in the former. However, skin necrosis over the prepared scalp artery occurred in the latter. The present method is simple and thought to be clinically useful for preventing of skin necrosis along scalp arteries prior to harvesting.