Double‐free, flow‐through flap reconstruction for complex scalp defects: A case report

Abstract

This case report describes the use of a double-free, flow-through flap as a valuable tool in reconstruction following oncological resection of a large, fungating, squamous cell carcinoma extending through the scalp, forehead, skull, and dura. An anterolateral thigh flap was utilized to supply: soft tissue for the forehead reconstruction, vascularized fascia lata for the dural repair, and to act vascular conduit to supply a distally placed latissmus dorsi flap for total scalp reconstruction. We believe this is the first time this combination of double-free, flow-through flap design has been published for the reconstruction of complex, composite scalp and calvarial defects.

Recurrent squamous cell carcinoma of the scalp treated with serial free flaps: A case report

“…Haddock et al presented in their case report, a 66‐year‐old man with at large scalp tumor, where the defect was reconstructed in a single stage procedure with the use of two free flaps, a ALT flap and a LD. The ALT flap functioned as a free, flow‐through flap, to support the larger LD flap and provided vascularized fascia lata for dura repair.…”

Free perforator flap transfer for reconstruction of skull base defects after resection of advanced recurrent tumor

“…However, the patient may need to change position during the surgery. Double‐free flaps such as bilateral ALT flaps or a double‐free flap composed of an ALT flap and a latissmus dorsi flap are other options for the reconstruction of larger, composite scalp, and calvarial defects . Dural reconstruction methods were chosen according to the dural defect size after tumor resections and the donor site choice.…”

“…Double-free flaps such as bilateral ALT flaps or a double-free flap composed of an ALT flap and a latissmus dorsi flap are other options for the reconstruction of larger, composite scalp, and calvarial defects. 15,16 Dural reconstruction methods were chosen according to the dural defect size after tumor resections and the donor site choice. We usually used the fascia lata for dural reconstruction in combination with the ALT flap.…”

Scalp and Dura Matter Complex Reconstruction Using Free Anterolateral Thigh Flap with Vascularized Fascia

“…Wide excision of the tumor, skull, and dura was performed by a neurosurgeon and a plastic surgeon (Figure 2(b)). The size of the defect of the dura was 120 cm 2 . We harvested 20 × 15 cm ALT with 15 × 10 cm fascia (Figure 2 defect site.…”