2024/09/30 by Olimpiu Bota, Franziska Beyer, Bota, Olimpiu +9
Medicine · #Infektion #Kopfhautrekonstruktion #Lappenplastik #Medicine and health #Neurochirurgie #Reconstructive Facial Surgery Techniques #Reconstructive Surgery and Microvascular Techniques #Schädelplastik #Tissue Engineering and Regenerative Medicine #cranioplasty #flap surgery #infection #neurosurger #plastic surgery #plastische Chirurgie #scalp reconstruction
paper · doi:10.3205/iprs000187
openalex publication_date 2024/09/30 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Introduction: Scalp defect reconstruction requires interdisciplinary cooperation to restore soft tissue and osseous defects. While wound closure and form restoration, often a short-term treatment goal, ensures patient survival, the long-term preservation of the head and neck's integrity and aesthetics is crucial for maintaining quality of life. This study aims to compare, quantify, and establish a safe and reproducible approach to various reconstruction options and the postoperative complication profile for individual scalp defect areas. Materials and methods: We retrospectively evaluated patients who underwent scalp reconstruction at our institution between March 2017 and April 2022. The inclusion criterion was the presence of a soft tissue defect at the cranium level. Results: ), and an average of 3±2 surgeries had been performed before the plastic surgical treatment was initiated. Eleven patients had only a soft tissue defect, while 20 patients had an associated bone defect. Fifteen of these patients received a cranioplasty. The rotation flap was the most frequently used (n=23), with or without split-thickness skin grafting, followed by the free latissimus dorsi muscle flap with split-thickness skin grafting (n=5), and the free lateral arm flap (n=2). Revision surgeries were necessary in 38.7% of cases due to wound healing disorders (n=9), bleeding (n=2), and cerebrospinal fluid leaks (n=1). Eventually, all wounds were successfully closed. Conclusion: Complex scalp defects can be closed using local flaps, thereby restoring aesthetics and tissue integrity. Free flaps remain a reliable solution for extensive defects. Moreover, in cases requiring cranioplasty, careful preoperative planning and an uncontaminated wound are essential for successful treatment.