Use of scalp flaps as a salvage procedure in reconstruction of the large defects of head and neck region

Abstract

ABSTRACTaIM: Large defects of the scalp, head and neck region are often encountered by plastic surgeons. The repair of such defects is dependent upon their location, size and depth. This study describes the use of large scalp flaps as a salvage procedure in the reconstruction of large scalp, head and neck region defects in elderly patients with poor general condition or advanced malignancy. MaterIaL and MetHOds:The presented study includes 22 patients operated between 2007 and 2011 for the reconstruction of large defects of the hair-bearing skin and head/neck region with large scalp flaps. A defect exceeding 25 cm 2 area was classified as "large" as defined in the previous studies. The patients' medical records were analyzed. resuLts: Scalp flaps provided a satisfactory and durable reconstruction in the late follow-up term. All flaps were completely survived except in one case in which a partial necrosis in the distal margin occurred. Major complications were recorded in 4.5% of patients while minor complications were recorded in 13.5% of them. cOncLusIOn:In conclusion, large scalp flaps should be considered as a salvage procedure for reconstruction of large scalp, head and neck defects especially for palliative situations in elderly patients with significant comorbidities and advanced malignancies. sOnuÇ: Sonuç olarak, geniş skalp flepleri, ciddi komorbiditesi olan veya ileri kanser olgularında, yaşlı hastalarda özellikle palyatif durumlarda, geniş skalp ve baş boyun bölgesi defektlerinin rekonstrüksiyonunda, kurtarıcı bir posedür olarak dikkate alınmalıdır.anaHtar sÖZcÜkLer: Skalp defekti, Geniş skalp flebi, Baş ve boyun defekti, Skalp rekonstrüksiyonu, Baş ve boyun rekonstrüksiyonu, Saçlı deri defekti

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“…A multidisciplinary approach including a neurosurgeon along with a plastic surgeon is often necessary to ensure safe tumor extirpation and effective reconstruction. In patients with extensive malignancies, like ours, survival takes precedence over function and esthetics [ 60 , 61 ]. Patients requiring radiation therapy present with added problems.…”

Evaluation of Local Axial Flaps in Scalp Defects Reconstruction

“…Elderly patients with poor general condition and comorbid disorders or the patients with advanced malignancies are poor candidates for complicated, long lasting and staged surgical procedures. These patients require safe, reliable and durable defect covering a quick manner (Egemen et al, 2012).…”