Double Hatchet Flap For The Reconstruction Of Scalp Defects

Varela-Veiga, Ana; Suárez-Magdalena, Olaya; Suárez-Amor, Óscar; Monteagudo, Benigno

doi:10.1016/j.adengl.2017.08.006

Cited by 1 publication

(8 citation statements)

References 3 publications

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“…3 Due to the limited elasticity in the scalp area, surgical treatment of cutaneous tumours proves to be a serious problem precisely because of the difficult to mobilize, transpose or rotate the unaffected skin adjacent to the intraoperative skin defect. 4 The presence of sun damaged skin in the scalp area complicates the management. 4 It is important to note that, in general, transposition and purely advancement flaps are generally less and less commonly used in the scalp, as opposed to rotational or combined rotational-advancement flaps for example.…”

Section: Discussionmentioning

confidence: 99%

“…4 The presence of sun damaged skin in the scalp area complicates the management. 4 It is important to note that, in general, transposition and purely advancement flaps are generally less and less commonly used in the scalp, as opposed to rotational or combined rotational-advancement flaps for example. 4 These techniques are also the last option to cover defects, especially in tumours that affect the periosteum, external tabula, diploe and/or internal tabula.…”

Section: Discussionmentioning

confidence: 99%

“…4 It is important to note that, in general, transposition and purely advancement flaps are generally less and less commonly used in the scalp, as opposed to rotational or combined rotational-advancement flaps for example. 4 These techniques are also the last option to cover defects, especially in tumours that affect the periosteum, external tabula, diploe and/or internal tabula. It is due to this fact that the vascularization/ vitality of the flap is crucial for the optimal final cosmetic result or the preservation of its integrity.…”

Section: Discussionmentioning

confidence: 99%

“…It is due to this fact that the vascularization/ vitality of the flap is crucial for the optimal final cosmetic result or the preservation of its integrity. 4 The so-called double hatchet flap is in fact a mixed type of flap that contains components of both rotation and advancement flaps, which makes it in itself a unique entity. 5 These two combined flaps and / or the so-called double hatchet flap create preconditions for a parallel reduction of the stress in the area of the skin defect that has occurred for covering.…”

Section: Discussionmentioning

confidence: 99%

“…6 It is based on the simple rule that the length of the plastic should correspond to 1.5 times the diameter of the tumour or the resulting defect, and the size of the vascular, feeding foot -should correspond to at least 1/3 of the length of the flap. 4 The question remains whether preoperative skin biopsy to optimize primary resection fields should be the rule or rather the exception in suspected non-melanocytic skin tumours (clinical/dermatoscopic). 7,8 We have presented a successfully performed double hatchet flap in the occipital scalp zone in a 65-year-old patient with subsequent histopathologically verified trichoepithelioma (Figures 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Double hatchet flap as adequate dermatosurgical approach for tumours of the occipital scalp zone: Presentation of two cases

Tchernev¹,

Lozev²,

Batashki³

et al. 2022

Dermatol Reports

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Tumors of the scalp remain a serious challenge for clinicians since poor locoregional skin elasticity hinders the ability to utilise certain flaps, limiting the choice of reconstructive techniques available. As a result, surgical restoration of medium to large-sized defects are left to the discretion of the surgeon, who with a comprehensive knowledge of restorative techniques, along with the advantages, limitations as well as a sound understanding of the locoregional anatomy, can make thorough decisions on the choice of which flap is best suited for the defect. Here we present two cases where the double hatchet flap was employed as a dermatosurgical approach in order to provide exceptional cosmetic results. On dermatological examination, both patients presented with a medium to large- sized tumour formation but were otherwise in good health. Both underwent radical, widelocal excision, followed by reconstructive manipulation in the form of a double hatchet flap to close the defect. Postoperative follow-up reported positive signs of wound healing with aesthetically pleasing results. Finally, we discuss the use of various flaps in such conditions while providing evidence for the double hatchet flap as a possible alternative that provides perfect aesthetic results as seen in our cases. Such a complex surgical intervention requires the expertise of a multidisciplinary team in order to achieve an overall successful outcome.

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Section: Discussionmentioning

confidence: 99%