Double-free, flow-through flap reconstruction for complex scalp defects: a case report.

Area of Science:

• Plastic Surgery
• Oncology
• Craniofacial Reconstruction

Background:

• Reconstruction of extensive scalp, forehead, skull, and dural defects following oncological resection presents significant challenges.
• Current reconstructive methods may not adequately address the composite nature of these defects, requiring innovative solutions.

Observation:

• A case report detailing the use of a double-free, flow-through flap for reconstruction after extensive squamous cell carcinoma resection.
• The anterolateral thigh flap served dual purposes: providing soft tissue for the forehead and vascularized fascia lata for dural repair.
• This flap also acted as a vascular conduit for a latissimus dorsi flap, enabling total scalp reconstruction.

Findings:

• Successful reconstruction of a large, fungating, squamous cell carcinoma defect involving the scalp, forehead, skull, and dura.
• Demonstration of a novel double-free, flow-through flap design combining anterolateral thigh and latissimus dorsi flaps.
• This technique effectively addressed both soft tissue and bony/dural deficits in a single-stage procedure.

Implications:

• This case highlights a potentially groundbreaking technique for complex craniofacial and scalp reconstruction.
• The double-free, flow-through flap offers a versatile and effective solution for challenging oncological defects.
• This approach may expand reconstructive options for surgeons managing extensive head and neck cancers.