Reconstruction of Extensive Scalp Defects With Anterolateral Thigh Flap

Altinkaya, Altug; Yazar, Sevgi Kurt; Sağlam, İbrahim; Gideroğlu, Kaan

doi:10.5505/tjtes.2018.94684

Cited by 9 publications

(14 citation statements)

References 20 publications

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“…Third, although no wound dehiscence occurred in the donor area after surgery, local necrosis was found at the donor site as a result of excessive tension. We agree with the reported recommendation that the donor area of the ALT flap should not be forcibly sutured when the width is greater than 10 cm, 6,7 and sometimes free skin grafting may be a better choice. In conclusion, the 1 pedicled double-island free ALT flap is a worthwhile choice for the reconstruction of complicated oral and maxillofacial tissue defects with an intraoral defect.…”

Section: Discussionsupporting

confidence: 89%

“…ALT reconstruction of large head and neck defects after tumor resection has been widely reported in the literature, 4,[6][7][8] but there have been few reports of cases involving the reconstruction of large head and neck defects after trauma. In contrast with tumor resection, defect wounds resulting from trauma injuries, especially from animal attacks, are usually infected, with extensive loss of soft tissue and bone.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of an Extensive Maxillofacial Avulsion Injury Caused by Bear Attack With a Double-Island Anterolateral Thigh Free Flap

Yang

Long

et al. 2021

Journal of Craniofacial Surgery

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Bear attack, a relatively rare cause of maxillofacial trauma, could lead to severe facial deformity as well as functional impairment. A 45-year-old male ranger was attacked by a bear and suffered an extensive maxillofacial avulsion injury, resulting in massive soft tissue loss (17.5 Â 10 cm 2 ) on his left temporal-facial region with an intraoral defect (3 Â 2 cm 2 ), surrounded by pus and necrotic tissue. Computed tomography revealed a comminuted fracture of the mandible, as well as bone defects in the left zygomatic bone, zygomatic arch, and part of the lateral orbital wall. in contrast with tumor resection, this large defect wound resulting from trauma was an infected wound with extensive loss of soft tissue and bone, which presented many operational challenges. The initial goal was to control local infection and then repair the maxillofacial and intraoral defects simultaneously. The left oral mucosal lining and maxillofacial skin after infection control were repaired by transposition of a double-island anterolateral thigh flap, and the fractured mandible was fixed, achieving primary closure for the reconstruction of large soft and hard tissue injuries in the oral and maxillofacial region. Five months postoperatively, the flap had healed and the patient was satisfied with the profile. This patient demonstrated how a rare severe injury caused by a bear attack was treated by preliminary closure of an extremely large post-traumatic oral and maxillofacial defect. The authors recommend the 1 pedicled double-island free anterolateral thigh flap as a worthwhile choice for the reconstruction of complicated oral and maxillofacial tissue defects combined with an intraoral defect. To our knowledge, this is the largest clinical application reported to date of an anterolateral thigh flap (approximately 200 cm 2 ) for a post-traumatic oral and maxillofacial defect.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Reconstruction of an Extensive Maxillofacial Avulsion Injury Caused by Bear Attack With a Double-Island Anterolateral Thigh Free Flap

Yang

Long

et al. 2021

Journal of Craniofacial Surgery

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“…However, the advent of microvascular free tissue transfers in 1959 has greatly expanded the options and versatility of reconstruction [21] . It provides consistently vascularized tissue and more robust soft tissue volume, especially important if postoperative radiation is pursued [22] . Thus, it has been established as an efficacious method.…”

Section: Discussionmentioning

confidence: 99%

The role of Integra in the reconstruction of full-thickness scalp defects

Yang¹,

Wu²,

Pittman³

2021

PAR

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“…Scalp reconstruction after melanoma excision deserves further important considerations. In our review, the age of patients ranged from 24 13 to 87 22 years, which leads us to consider several variables: for example, the importance of obtaining an aesthetically acceptable result and the complexity of the surgical procedure that the patients can handle. Young patients generally demand reconstructions that provide for the presence of hair and that can quickly help them recover a normal social life.…”

Section: Discussionmentioning

confidence: 99%

“…The reconstruction methods described in the selected articles ranged from skin grafting, whether 14 , 15 , 19 , 21 , 22 or not 20 preceded by a bovine collagen construct, to local flaps (associated 26 – 28 or not 16 , 24 , 25 with skin grafting), local pedicle flaps (with skin graft of the donor area), 12 and free flaps. 13 , 17 , 18 , 23 In 1 patient, the one with the largest defect described, bilateral free ALT flaps were harvested. 23 Reconstructive techniques, based on the depth and width of the scalp defect, are summarized in Table 3 .…”

Section: Reconstruction Strategiesmentioning

confidence: 99%

Surgical Reconstruction following Wide Local Excision of Malignant Melanoma of the Scalp

Baldelli

Mangialardi

Salgarello

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Scalp reconstruction in cases of melanoma excision can be challenging due to specific functional and aesthetic outcome requirements. Reconstructive techniques reported in the literature were reviewed to establish whether a surgical algorithm for the management of melanoma of the scalp may be deduced. Methods: A literature search was conducted to evaluate reconstructive strategies after melanoma wide local excision of the scalp according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria were English language, diagnosis of melanoma of the scalp, and the presence of the following data: characteristics of the residual defect (width and depth), type of reconstruction, follow-up, and surgical outcome. Results: Six hundred twenty-five records were identified after excluding the duplicates; 48 full-text articles were assessed for eligibility, and 17 records were selected for inclusion. A total of 39 patients were included in the review. The majority of patients (n = 20) underwent skin grafting subsequent to dermal regeneration template positioning. Local flaps (n = 10), free flaps (n = 7), skin grafting alone (n = 1), and dermal regeneration template positioning alone (n = 1) were less frequent. Conclusions: Numerous reconstructive strategies for the scalp are described in the literature. Melanoma patients present a greater variability in terms of general health conditions and social needs that must be taken into account while choosing the most suitable procedure.

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Reconstruction of Extensive Scalp Defects With Anterolateral Thigh Flap

Abstract: BACKGROUND: Extensive scalp defects caused by various etiologies often require free-tissue transfer. We aimed to review our experience in the reconstruction of extensive scalp defects with free anterolateral flaps.

Cited by 9 publications

References 20 publications

Reconstruction of an Extensive Maxillofacial Avulsion Injury Caused by Bear Attack With a Double-Island Anterolateral Thigh Free Flap

Reconstruction of an Extensive Maxillofacial Avulsion Injury Caused by Bear Attack With a Double-Island Anterolateral Thigh Free Flap

The role of Integra in the reconstruction of full-thickness scalp defects

Surgical Reconstruction following Wide Local Excision of Malignant Melanoma of the Scalp

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