Scalp and forehead reconstruction using free revascularized tissue transfer. Archives of facial plastic surgery : official publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies. [Arch Facial Plast Surg] Journal article | | Title | Scalp and forehead reconstruction using free revascularized tissue transfer. | | Author(s) | Beasley NJ, Gilbert RW, Gullane PJ, Brown DH, Irish JC, Neligan PC | | Institution | Wharton Head and Neck Centre, Princess Margaret Hospital, Toronto, Ontario, Canada. | | Source | Arch Facial Plast Surg 2004 Jan-Feb; 6(1):16-20. | | MeSH | Adult
Aged
Aged, 80 and over
Bone Neoplasms
Female
Forehead
Humans
Male
Melanoma
Middle Aged
Reconstructive Surgical Procedures
Scalp
Tissue Transplantation
| | Abstract | OBJECTIVE: To examine the indications for, and the success of, free flap reconstruction in patients with forehead and scalp defects.
DESIGN: Case series.
SETTING: Two tertiary referral university teaching hospitals.Patients Twenty-six consecutive patients, aged 31 to 85 years, presenting with 26 scalp defects, 5 forehead defects, and 1 combined defect (size, 70-672 cm(2)). Three patients required resection and repair of the dura at surgery.Intervention Patients were staged according to the size of the defect and the viability of surrounding tissue; free flap reconstruction was performed where indicated.
MAIN OUTCOME MEASURES: Flap survival, complications, and disease-free and overall survival.
RESULTS: Thirty-four free flap reconstructions were performed (24 latissimus dorsi free flaps, 4 scapular free flaps, 3 rectus abdominis free flaps, and 3 radial forearm free flaps). One failed 2 weeks postoperatively, and 2 required exploration (1 for arterial ischemia and 1 for a hematoma). There were 3 cases of donor site morbidity (2 early seromas and 1 late abdominal hernia). One patient died of a pulmonary embolus 1 week postoperatively. Disease-free survival was 48% at 5 years and overall survival was 59% at 5 years, with a median follow-up of 24 months.
CONCLUSIONS: Free revascularized tissue transfer is a reliable and safe way of reconstructing large scalp or forehead defects after traumatic injury or neoplastic resection. The muscle-only latissimus dorsi free flap for scalp reconstruction and the cutaneous scapular free flap for the forehead have proved successful in selected patients with a low complication rate and satisfactory cosmesis. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 14732639 |
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