Application of Local Axial Flaps to Scalp Reconstruction

• Main Authors: Yolanda Zayakova, Anton Stanev, Hristo Mihailov, Nicolai Pashaliev
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2013-09-01
• Series: Archives of Plastic Surgery
• Subjects: Surgical flaps; Burn; Basal cell carcinoma; Reconstructive surgical procedures; Scalp
• Online Access: http://www.e-aps.org/upload/pdf/aps-40-564.pdf

BackgroundScalp defects may be caused by various etiological factors, and they represent a significant surgical and aesthetic concern. Various surgical techniques can be applied for reconstructive work such as primary closure, skin grafting, pedicled or free flaps. In this article, the authors share their clinical experience with scalp operations using the technique of local flaps and discuss the application of this method from the perspective of not only the size of the defect, but also in relation to the anatomical area, quality of surrounding tissue, and patient's condition.MethodsDuring the period from December 2007 to December 2012, 13 patients with various scalp defects, aged 11 to 86 years, underwent reconstruction with local pedicle flaps. The indications were based on the patients' condition (age, sex, quality of surrounding tissue, and comorbidities) and wound parameters. Depending on the size of the defects, they were classified into three groups as follows: large, 20 to 50 cm2; very large, 50 to 100 cm2; extremely large, 100 cm2. The location was defined as peripheral (frontal, temporal, occipital), central, or combined (more than one area). We performed reconstruction with 11 single transposition flaps and 1 bipedicle with a skin graft on the donor area, and 2 advancement flaps in 1 patient.ResultsIn all of the patients, complete tissue coverage was achieved. The recovery was relatively quick, without hematoma, seroma, or infections. The flaps survived entirely.ConclusionsLocal flaps are widely used in scalp reconstruction since they provide healthy, stable, hair-bearing tissue and require a short healing time for the patients.