Repair of a Large, Full-Thickness Scalp Defect with Exposed Bone Using a Thin Transposition Flap

Shin, Thuzar M.; Bordeaux, Jeremy S.

doi:10.1111/dsu.12053

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Reconstruction of the scalp after tumor excision may include any of the following techniques: secondary granulation [ 1 ]; side-to-side closure [ 2 ]; the use of an advancement flap [ 3 ], rotation flap [ 4 ], or transposition flap [ 5 ]; tissue expansion; locoregional [ 6 ] or free flaps [ 7 – 9 ]; or the use of a split-thickness skin graft (STSG) or full-thickness skin graft (FTSG) [ 10 ]. Choosing one technique depends on anatomic and patient-related factors.…”

Section: Introductionmentioning

confidence: 99%

One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra)

Angelis

Gentile

Tati

et al. 2015

BioMed Research International

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The use of Dermal Regeneration Template (DRT) can be a valid alternative for scalp reconstruction, especially in elderly patients where a rapid procedure with an acceptable aesthetic and reliable functional outcome is required. We reviewed the surgical outcome of 20 patients, 14 (70%) males and 6 (30%) females, who underwent application of DRT for scalp reconstruction for small defects (group A: mean defect size of 12.51 cm2) and for large defects (group B: mean defect size of 28.7 cm2) after wide excision of scalp neoplasm (basal cell carcinoma and squamous cell carcinoma). In group A, the excisions were performed to the galeal layer avoiding pericranium, and in group B the excisions were performed including pericranium layer with subsequent coverage of the exposed bone with local pericranial flap. In both the groups (A and B) after the excision of the tumor, the wound bed was covered with Dermal Regeneration Template. In 3 weeks we observed the complete healing of the wound bed by secondary intention with acceptable cosmetic results and stable scars. Scalp reconstruction using a DRT is a valid coverage technique for minor and major scalp defects and it can be conducted with good results in elderly patients with multiple comorbidities.

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Section: Introductionmentioning

confidence: 99%

One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra)

Angelis

Gentile

Tati

et al. 2015

BioMed Research International

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“…Local flaps can be used successfully for coverage of moderately sized scalp defects with hair-bearing tissue, especially with sufficient undermining. Yet it is not adequate in patients with large defects due to insufficient elasticity of scalp tissue 8 . In these instances, a large scalp rotation flap can be raised to transfer the defect to a less esthetically sensitive area with back-grafting of the donor site 15 .…”

Section: Discussionmentioning

confidence: 99%

“…Another issue is the patients' expectations of cosmetic appearance 5 . There are many reconstructive modalities to be selected according to the size and depth of scalp defects, including primary closure 6 , tissue expansion 7 , local flaps 8 , skin grafts 9 , distant pedicled flaps 5 , or free flaps 1 . Nevertheless, each therapeutic option has its advantages and limitations.…”

Section: Introductionmentioning

confidence: 99%

Single Stage Reconstruction of Large Calvarial Exposure after Tumor Resection: A 3-Year Experience

Mahmoud

2021

wjps

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BACKGROUND We aimed to review the treatment and outcome of patients’ undergone reconstruction of large full thickness scalp defects with exposed calvarium after oncologic resection with the combined local flap and split-thickness skin graft (STSG) technique. METHODS A retrospective review of 45 patients with scalp defects secondary to tumor extirpation was performed at the Plastic Surgery Department, Tanta University Hospital, Tanta, Egypt from Nov 2016 to Nov 2019. Patients, with large (>50 cm2) and full-thickness (exposed calvarium) scalp defects, who underwent scalp reconstruction with the combined local flap and STSG technique and had completed their medical records were enrolled. RESULTS Only 38 met the inclusion criteria. Thirty-three were male (86.8). The mean age was 61.5 years. The lesions removed were BCC in 30 cases (78.9%) and SCC in 8 cases (21.1%). Defect sizes ranged from 55 to 196 cm2. There was complete survival of all flaps. Complications were noticed in 5 patients (13.2%);2 developed small hematomas, 2 suffered from partial graft losses and one had wound infection. The follow-up period ranged from 6 to 27 months. Overall, 34 patients were satisfied with the functional and cosmetic results (89.5%), while 4 female patients weren't satisfied with the esthetic results (10.5%). CONCLUSION The combination of local flap and skin graft technique is highly reliable, easy to perform and safe single-stage reconstructive modality of large skull exposed scalp defects, providing durable coverage and favorable esthetic outcome.

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“…Scalp defects with exposed bone are best reconstructed with flaps. Small defects are routinely repaired with local scalp flaps as either advancement flaps or transposition or rotational flaps [ 1 – 4 ]. Extensive defects on the other hand are mainly reconstructed with free flaps [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound

Nangole

Khainga

2017

Case Reports in Surgery

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Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity.

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Repair of a Large, Full-Thickness Scalp Defect with Exposed Bone Using a Thin Transposition Flap

Cited by 7 publications

References 9 publications

One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra)

One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra)

Single Stage Reconstruction of Large Calvarial Exposure after Tumor Resection: A 3-Year Experience

Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound

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