Closure of Scalp and Forehead Defects Using External Tissue
                        Expander

O’Reilly, Ashley G.; Schmitt, William R.; Roenigk, Randall K.; Moore, Eric J.; Price, Daniel L.

doi:10.1001/archfaci.2012.662

Cited by 20 publications

(5 citation statements)

References 8 publications

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“…Typical options in the reconstructive ladder commonly used in head and neck reconstruction have limited utility repairing large scalp defects 1,5. Primary closure is often effective but is limited to defects <3 cm in diameter,1 while healing by secondary intention relies on the presence of underlying periosteum. Skin grafts used in cases of exposed calvarium offer poor skin, color, and texture matching.…”

Section: Discussionmentioning

confidence: 99%

“…External tissue expanders have been successfully used in closing large scalp defects with good results 1–3. CETE takes advantage of the elastic properties of the skin to increase the surface area near the wound and reduce the size of the defect 5.…”

Section: Discussionmentioning

confidence: 99%

“…Reconstruction of scalp defects presents a unique challenge for plastic and reconstructive surgeons. The limited flexibility of the scalp and hair-bearing nature makes it difficult to repair tissue defects with tissue that is similar in color, thickness, and texture 1. Tissue expansion is an effective method that can overcome these barriers in scalp reconstruction 1–4.…”

mentioning

confidence: 99%

“…The limited flexibility of the scalp and hair-bearing nature makes it difficult to repair tissue defects with tissue that is similar in color, thickness, and texture 1. Tissue expansion is an effective method that can overcome these barriers in scalp reconstruction 1–4. The scalp is ideal for use of external tissue expanders, such as the DermaClose (Synovis Micro Companies Alliance Inc., Birmingham, AL) continuous external tissue expansion.…”

mentioning

confidence: 99%

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Closure of a Large Scalp Defect Using External Tissue Expansion

Shikara

Waghmarae

Vakharia

2022

Journal of Craniofacial Surgery

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The limited laxity of the scalp and hair-bearing nature makes it difficult to optimally repair. Primary closure is limited to small defects, while healing by secondary intention requires underlying periosteum. Furthermore, the use of free flaps and skin grafting can lead to unfavorable cosmetic outcomes. This report describes a patient with a large parietal scalp dermatofibrosarcoma protuberans. Multiple resections resulted in a large scalp defect with exposed calvarium. Integra was placed over the exposed calvarium after each debridement and Negative Pressure Wound Therapy (NPWT) was applied. After granulation tissue formed, 2 DermaClose continuous external tissue expansion systems were installed. Following the application and tightening of the external tissue expanders, the wound was reduced in size, facilitating primary closure of the opposing edges. This process allowed for a large area to be covered with hair-bearing scalp with good cosmetic results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Closure of a Large Scalp Defect Using External Tissue Expansion

Shikara

Waghmarae

Vakharia

2022

Journal of Craniofacial Surgery

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“…Tissue expansion does require a stable calvarial base and adequate expandable tissue (>50% of scalp), as well as a patient who is able to remain compliant to prolonged expansion and staged procedures. 4,8 In cases where defects were large (>100 cm 2 ) and there was insuffi cient local tissue for recruitment, microsurgical reconstruction with free fl aps enabled the transfer of large amounts of composite tissue to the scalp. 9 In these cases, due to the size of the defects and exposed underlying structures expedient durable coverage is the aim and hair-bearing tissue should no longer be a primary consideration.…”

Section: Discussionmentioning

confidence: 99%

Optimising Aesthetic Reconstruction of Scalp Soft Tissue by an Algorithm Based on Defect Size and Location

Ooi

Kanapathy

Ong

et al. 2015

Ann Acad Med Singap

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Introduction: Scalp soft tissue defects are common and result from a variety of causes. Reconstructive methods should maximise cosmetic outcomes by maintaining hair-bearing tissue and aesthetic hairlines. This article outlines an algorithm based on a diverse clinical case series to optimise scalp soft tissue coverage. Materials and Methods: A retrospective analysis of scalp soft tissue reconstruction cases performed at the Singapore General Hospital between January 2004 and December 2013 was conducted. Results: Forty-one patients were included in this study. The majority of defects <100 cm2 were reconstructed with local flaps and were subdivided by location. Methods included rotation, transposition and free flaps. The most common type of reconstruction performed for defects ≥100 cm2 was free flap reconstruction. Multistage reconstruction using tissue expanders aided in optimising cosmetic outcomes. There were no major complications or flap failures. Conclusion: By analysing our experience with scalp soft tissue reconstruction, we have developed an algorithm based on defect size and location, achieving excellent closure and aesthetic outcome while minimising complications and repeat procedures. Key words: Flaps, Reconstruction Algorithm, Scalp

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