Bipedicle Frontal-Occipital Flap for Reconstruction of Post Avulsion Injury of Scalp Temporoparietal Region: A Case Report

Krishna, Deepak; Khan, Manal M; Laitonjam, Michael

doi:10.52547/wjps.10.3.121

Cited by 1 publication

(2 citation statements)

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“…Fronto-occipital (Figure 7 , Panels A-D) and temporo-temporal bipedicle flaps (Figure 8 , Panels A-C) have excellent coverage scales for bone-deep temporal and frontal defects associated with injury to vascular pedicle or where free flap could not be performed due to any reason [ 19 , 20 ]. Large full-thickness defects at the occipital region can also be covered with a pedicle trapezius flap.…”

Section: Discussionmentioning

confidence: 99%

“…In avulsion injuries, you may find an injured vascular pedicle sometimes, which necessitates using a vein graft or arterio-venous loop to use recipient vessels outside the trauma zone [3]. Fronto-occipital (Figure 7, Panels A-D) and temporo-temporal bipedicle flaps (Figure 8, Panels A-C) have excellent coverage scales for bone-deep temporal and frontal defects associated with injury to vascular pedicle or where free flap could not be performed due to any reason [19,20]. Large full-thickness defects at the occipital region can also be covered with a pedicle trapezius flap.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reconstruction of Scalp and Forehead Defects: Options and Strategies

Krishna¹,

Khan²,

Dubepuria³

et al. 2023

Cureus

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Background Aesthetic reconstruction of scalp and forehead defects with local flaps and minimal donor site morbidity is the primary goal of coverage. While selecting the coverage technique, essential factors such as size, location, and components of a defect, hair-bearing or non-hair-bearing nature of skin, status of the exposed skull, need for radiation, patient condition, availability of local tissue, and the potential for hairline distortion should be kept in mind. Materials and methods This is a retrospective analysis in which 54 patients who underwent soft tissue reconstruction of the scalp and forehead defects were included. The defect size was categorized into four groups: small: <4 cm 2 , medium: 4-50 cm 2 , large: 50-200 cm 2 , and very large: >200 cm 2 . Reconstruction of all defects was done according to the defect's size, location, and depth. All patients were regularly followed at intervals of two weeks, six weeks, and three months, respectively. The outcome was evaluated in terms of flap survival, flap coverage scale, the requirement of secondary treatment, postoperative complications, and final aesthetic appearance. Results In 54 consecutively treated patients with scalp and forehead defects, the male-to-female ratio was 2:1, and the overall mean age of participants was 34.8 years, ranging from 0.5 to 66 years. The most common etiology of the defect was trauma (16; 29.6%), and the most common location of the defect was combined (16; 29.6%). Rotation flap and primary closure were the most commonly performed procedure, each 12 (22.2%) in number. Out of 12 primary closure cases, two patients developed wound dehiscence because of infection. All cases of skin grafting healed well. All cases of transposition flap with skin grafting at the donor site went uneventful, and the dog ear at the base was revised later. One case of the bipedicle flap in which partial graft loss occurred at the donor area was managed with regrafting. Two cases of single rotation flap, one double rotation flap, and one free latissimus dorsi muscle flap developed distal necrosis. The excellent aesthetic outcome was found in all cases of primary closure and single and double rotation flaps. Conclusions Local flaps have an architecture similar to the recipient site, and low donor site morbidity results in an aesthetically more pleasant outcome. In our experience, scalp defects up to 50 cm 2 were covered with the local scalp flaps with primary closure of the donor area. Defects ranging from 50 to 200 cm 2 required local scalp flap with skin grafting at the donor area. Free tissue transfers are usually needed when the defect is very large, devoid of the periosteum, or with the calvarial defect.

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Section: Discussionmentioning

confidence: 99%