[A simple and effective technique for reconstructive surgery of medium-sized scalp defects]

From June to December 1999, eight patients aged from 16 to 30 years with scalp defects ranging from 9-11 cm in the tonsural region secondary to high-voltage electrical burns underwent scalp reconstruction via a technique based on the Orticochéa method, but which was less complicated in design, easier to carry out, and also more efficient. The entire scalp was prepared for surgery subgalea, but in no case was the dura mater exposed. Then four local flaps were taken, i.e., two temporal, one frontal, and one occipital flap. The width of each flap was the same size as the diameter of the scalp defect, and the base of each flap included the main regional blood vessels: A straight-forward advancement technique for the four flaps was not sufficient to completely cover such scalp defects, and a rotational approach was also introduced. In fact, the originality of the presently-described technique lies in the rotational approach, which is extremely efficient. It is carried out via three backcuts, beginning with the first temporal flap, then the second temporal flap, and if necessary the occipital flap; but never the frontal flap. These backcuts are performed in such a way that they are subsequently hidden by hair growth. In the present study, no skin graft was necessary, and no complications were reported. All the patients were satisfied with the results of surgery, both as regards the cosmetic aspect and regrowth of hair, and also as regards scalp sensitivity.