Reconstruction of Scalp Wounds with Exposed Calvarium Using a Local Flap and a Split‐Thickness Skin Graft: Case Series of 20 Patients. Issue 3 (18th January 2014)

• Record Type: Journal Article
• Authors: Aldabagh, Bishr; Cook, Jonathan L.
• Is Part Of: Dermatologic surgery. Volume 40:Issue 3(2014)
• Page Start: 257
• Page End: 265
• Publication Date: 2014-01-18
• Subjects: Skin -- Surgery -- Periodicals; Skin -- Diseases -- Surgery -- Periodicals; 617.477
• DOI: 10.1111/dsu.12412
• Languages: English
• ISSNs: 1076-0512

Abstract

<abstract abstract-type="main" id="dsu12412-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dsu12412-sec-0001" sec-type="section"> <title>Objectives</title> <p>To describe the design, execution, outcomes, and advantages of a combined flap and split‐thickness skin graft reconstructive technique for the repair of wounds of the scalp with exposed bone after Mohs micrographic surgery.</p> </sec> <sec id="dsu12412-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>An analysis of the combined flap and graft technique of 20 scalp defects ranging in size from 6.25 to 37.6 cm<sup>2</sup> is provided. Surgical defects and patient characteristics are described. Follow‐up information is reviewed, and complications and final aesthetic results are reported.</p> </sec> <sec id="dsu12412-sec-0003" sec-type="section"> <title>Results</title> <p>Twenty patients with 20 tumors on the scalp (16 squamous cell carcinoma, 2 basal cell carcinoma, 1 Merkel cell carcinoma, and 1 malignant fibrous histiocytoma) were treated using Mohs micrographic surgery. A combined flap and graft technique was successfully employed with good aesthetic outcomes in all 20 patients with broad scalp defects. One postoperative complication of approximately 20% skin graft necrosis was noted. One methicillin‐resistant <italic>Staphylococcus aureus</italic> postoperative wound infection occurred but resolved without sequelae with appropriate antibiotic treatment.</p> </sec> <sec id="dsu12412-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The described flap and graft reconstructive technique is a reproducible, one‐stage procedure for the reconstruction of medium to large scalp defects with exposed bone, obviating the need for more‐complicated, costly, time‐consuming procedures.</p> </sec> <sec id="dsu12412-sec-0005" sec-type="section"> <title>Limitations</title> <p>Small sample size, descriptive study.</p> </sec> </abstract>