Double scalping flap: a versatile technique in scalp reconstruction.

Area of Science:

• Plastic Surgery
• Surgical Oncology

Background:

• Scalp reconstruction presents significant challenges due to exposed brain tissue risk and the need for adequate soft tissue coverage in full-thickness defects.
• Malignant scalp lesions require reconstructive strategies that ensure local disease control and facilitate monitoring for recurrence or metastasis.
• Patient comorbidities and age often preclude lengthy or multistage surgical procedures.

Observation:

• The double scalping flap is a single-stage procedure suitable for most full-thickness scalp defects on the vertex.
• Advantages include versatility, wide arc of rotation, minimal donor site morbidity, simplicity, and a short operative time.
• Potential disadvantages involve hair-bearing skin loss and color/texture mismatch with split-thickness skin grafts at the donor site.

Findings:

• The double scalping flap was successfully employed in two cases of neglected scalp malignancy, demonstrating its efficacy.
• This technique provides a viable option for complex scalp defects, balancing reconstructive needs with patient condition.
• Comparison with alternative methods highlights the double scalping flap's specific benefits in selected cases.

Implications:

• The double scalping flap represents an efficient and effective reconstructive option for complex scalp defects, especially in elderly or comorbid patients.
• It offers a valuable alternative for managing malignant scalp tumors, potentially improving patient outcomes and quality of life.
• Further investigation into optimizing aesthetic outcomes and minimizing donor site morbidity is warranted.