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Closure of scalp and forehead defects using external tissue expander
Ashley G O'Reilly1, William R Schmitt, Randall K Roenigk
1Division of Otorhinolaryngology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Archives of Facial Plastic Surgery
|September 5, 2012
Summary
External tissue expanders offer a safe method for reconstructing scalp and forehead defects. This technique effectively reduces defect size, often enabling primary closure and avoiding complex reconstructive surgeries.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Scalp and forehead defects resulting from head and neck cancer extirpation pose significant reconstructive challenges.
- Traditional methods like skin grafting or free flap reconstruction have limitations and potential complications.
Purpose of the Study:
- To evaluate the efficacy and safety of using an external tissue expander for reconstructing large scalp and forehead defects.
- To describe the outcomes of this novel reconstructive approach.
Main Methods:
- A prospective review of 7 patients with scalp and forehead defects following malignant neoplasm removal.
- Reconstruction utilized an external tissue expander device, with data collection on clinical factors, defect size, and photographic outcomes.
Main Results:
- External tissue expanders were used for 6 to 14 days, reducing defect sizes by 50% to 99%.
- Primary closure was achieved in 5 patients; others required advancement rotation flaps or secondary intention healing.
- One patient with comorbidities required a free flap due to partial skin loss post-expansion.
Conclusions:
- External tissue expansion is a safe and effective reconstructive technique for large scalp and forehead defects.
- This method can potentially obviate the need for skin grafts or free flap reconstructions in many cases.
