Reconstruction of Scalp Defects with Free Flaps

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Author(s): M.R. Aslam, M. Rashid, I. Illahi, E.Haq, S.R. Sarwar

Received: 29/01/2023 | Published: 02/05/2023 | Pages: 26-30 |

We present our experience of reconstruction of six cases with large scalp defects. All repairs were performed for defects which resulted from tumour resections. Out of these six cases, three were of squamous cell carcinoma (SCC), two of basal cell carcinoma (BCC) and one case was of Haemangiopericytoma. The defects involved scalp with bone exposure in three patients. Resection of the outer table of the skull was done in one case. Extensive defect involving both inner and outer tables with exposed duramater occurred in one case, whereas in one of the cases the duramater had to be repaired. The average size of the defect ranged from 7 x 18 cm up to 15 x 25 cm. The flaps utilised for reconstruction included two radial forearm flaps, three latissimus dorsi muscle flaps with partial thickness grafts and one myocutaneous rectus abdominis flap. All flaps survived completely. No significant donor or recipient site complication occurred. Average hospital stay was 11 days (range 8 days to 14 days). Our experience confirms that in cases of complex or large scalp defects requiring reconstruction and where there is inadequacy of local tissue, microvascular transfer of well vascularized tissues with adequate bulk and size is the preferred option for single stage, successful reconstruction.