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Scalp and forehead reconstruction using free revascularized tissue transfer
Nigel J P Beasley1, Ralph W Gilbert, Patrick J Gullane
1Wharton Head and Neck Centre, Princess Margaret Hospital, Toronto, Ontario, Canada.
Archives of Facial Plastic Surgery
|January 21, 2004
Summary
Free flap reconstruction effectively repairs large scalp and forehead defects. This reliable method offers good outcomes for patients undergoing traumatic injury or neoplastic resection, with low complication rates.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Forehead and scalp defects often require complex reconstruction.
- Free flap reconstruction offers a viable solution for large defects.
Observation:
- A case series of 26 patients with large forehead and scalp defects (70-672 cm²) undergoing free flap reconstruction.
- Thirty-four free flap reconstructions were performed using various flap types, including latissimus dorsi, scapular, rectus abdominis, and radial forearm flaps.
Findings:
- Flap survival was high, with only one flap failure and two requiring exploration for ischemia or hematoma.
- Donor site morbidity was low (3 cases), and overall and disease-free survival rates at 5 years were 59% and 48%, respectively.
- Latissimus dorsi and scapular free flaps demonstrated success in scalp and forehead reconstruction, respectively, with satisfactory cosmesis.
Implications:
- Free revascularized tissue transfer is a safe and reliable technique for reconstructing extensive scalp and forehead defects.
- Specific free flap choices, like the latissimus dorsi for scalp and scapular for forehead, are effective in selected cases.
- This reconstructive approach can significantly improve patient outcomes following trauma or cancer surgery.