Galeal/periosteal flaps for the reconstruction of large scalp defects with exposed outer table

Galeal/Periosteal Rotation Flaps: A Novel Technique for Covering Exposed Forehead Bone

“…He used split‐ and full‐thickness skin grafts and found that periosteum alone could support grafts up to 12 × 7 cm. Hussain and colleagues showed that exposed scalp could be resurfaced with galeal/periosteal flaps, although they discouraged the use of full‐thickness skin grafts with galeal or galeal/periosteal flaps . Halpern illustrated that galeal flaps alone could provide sufficient perfusion for a full‐thickness graft on the scalp .…”

“…Complete epithelialization is estimated to take 3 weeks for every centimeter of bone width, or 12 weeks for a 4‐cm wound . Alternatively, galeal and galeal/periosteal flaps have been used on the scalp to facilitate granulation or to provide immediate vascular supply to an overlying skin graft, but how would one approach a large forehead defect extending to bare bone? We present an innovative method for same‐day repair of large forehead defects with exposed bone using a rotated galeal/periosteal flap and a full‐thickness skin graft.…”

Frontalis-based island pedicle flaps for the single-stage repair of large defects on the forehead and frontal scalp

“…Large wounds of the forehead may be managed by secondary‐intention wound healing which can be combined with cortical bone fenestration 8 when there is loss of the periosteum. Periosteal or galeal flaps may be used to facilitate a vascular bed to support skin grafting onto exposed frontal bone 9 …”

“…Periosteal or galeal flaps may be used to facilitate a vascular bed to support skin grafting onto exposed frontal bone. 9 The most commonly used local flaps in forehead reconstruction are advancement and rotation flaps. In repairing large scalp wounds the flap lengths need to be sufficient to generate the movement required which results from a combination of skin plasticity and secondary motion from surrounding skin following undermining.…”

Successful reconstruction of scalp and skull defects: Lessons learned from a large series

“…Treatment of scalp and skull defects is a challenging problem for reconstructive surgeons, in part because of the relative inelasticity of the surrounding skin 1. Despite wide undermining, only relatively small defects can be closed primarily.…”