Multiple-Flap Scalp Reconstruction

Arnold, Phillip G.; Rangarathnam, C.S.

doi:10.1097/00006534-198204000-00003

Cited by 26 publications

(11 citation statements)

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“…The Orticochea tripartite flap and its variants have been used for reconstruction of large central scalp defects. 10,11 In certain situations, galeal scoring may be performed to gain flap length and reduce tension. Although Raposio et al 12 found only modest improvements in flap length (1.67 mm per galeal incision) with galeal scoring, they found a 40% decrease in wound tension.…”

Section: Tissue Expansionmentioning

confidence: 99%

Scalp and Calvarial Reconstruction

Lin

Hanasono

Skoracki

2008

Seminars in Plastic Surgery

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Over the past several decades, an improved understanding of the blood supply of local flaps, increased experience with tissue expansion, and the development of techniques for microsurgical transfer of distant flaps have greatly contributed to the ability of plastic surgeons to repair scalp defects. This article will review basic anatomy, principles, and pearls of reconstruction for simple to complex scalp defects. Included will be anatomic considerations, indications and contraindications for reconstruction, and an overview of reconstructive options.

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Section: Tissue Expansionmentioning

confidence: 99%

Scalp and Calvarial Reconstruction

Lin

Hanasono

Skoracki

2008

Seminars in Plastic Surgery

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“…But, the long operative time, need of resources for these flaps is limitation. Hence, as for as possible, local tissues should be used for reconstruction of scalp [7,8]. Anatomically, scalp being highly vascular designing a flap and survival of flap is relatively better compared to other areas of body.…”

Section: Discussionmentioning

confidence: 99%

Scalp Rotation Flap-Minor Changes Major Gains

Manjunath¹,

Venkatesh²,

Vishwanath³

2017

Anaplastology

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“…9.13) and even the time-tested three-or four-flap techniques described by Orticochea. 15 Due to the incredible vascularity of the scalp, large scalp flaps can be rotated into position and back-grafted with split-thickness skin grafts, often solving difficult scalp wounds quickly, although with less than ideal cosmesis (Fig. 9.14).…”

Section: Expert Commentary By Michael R Zennmentioning

confidence: 99%

9 Scalp and Calvarial Reconstruction

2016

Reconstructive Plastic Surgery of the Head and Neck: Current Techniques and Flap Atlas

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9thorough understanding of the anatomical layers is important, particularly when rotation and advancement flaps are planned. In these cases, dissection should be performed within the loose areolar tissue layer to preserve the pericranium, in case skin grafting of the flap donor site is needed.Blood vessels, lymphatics, and sensory nerves are found within the subcutaneous layer, superficial to the galea aponeurotica. Blood vessels that supply the scalp and forehead include the paired supratrochlear, supraorbital, superficial temporal, posterior auricular, and occipital arteries and their accompanying veins ( Fig. 9.1a). The supratrochlear and supraorbital arteries arise from the ophthalmic artery, a branch of the internal carotid artery. The remaining arteries that supply the scalp originate from the external carotid artery. These blood vessels are the basis for axial flaps used in local flap reconstruction of scalp defects. Robust interconnections between vascular territories allow for relatively long and large flaps to be used reliably. Caudal to the nuchal line, blood vessels that perforate the trapezius and splenius capitis muscles supply the skin of the posterior scalp and nape of neck.Sensory nerves of the scalp are also paired and include the supratrochlear (V 1 ), supraorbital (V 1 ), zygomaticotemporal (V 2 ), auriculotemporal (V 3 ), lesser occipital (C2, C3), and greater occipital (C2) nerves (Fig. 9.1b). The supraorbital and supratrochlear nerves supply the forehead and frontoparietal scalp. The zygomaticotemporal nerve supplies the region lateral to the brow and the temporal scalp up to the temporal crest. The auriculotemporal nerve supplies the lateral scalp, and the greater and lesser occipital nerves supply the occipital region.Motor nerves in the scalp innervate the muscles of this region, which include the frontalis, temporalis, auricularis (anterior, superior, and posterior), and occipitalis muscles. Of these, the most clinically significant is the temporal branch of the facial nerve, which supplies the frontalis muscle. This branch is located on the deep surface of the temporoparietal fascia and

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Multiple-Flap Scalp Reconstruction

Cited by 26 publications

References 0 publications

Scalp and Calvarial Reconstruction

Scalp and Calvarial Reconstruction

Scalp Rotation Flap-Minor Changes Major Gains

9 Scalp and Calvarial Reconstruction

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