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Achievements in scalp reconstruction.

Nicole M Fowler1, Neal D Futran

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, Washington, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|February 8, 2014
PubMed
Summary

Scalp defect reconstruction is challenging. Microvascular free tissue transfer, including latissimus dorsi, anterolateral thigh (ALT), and radial forearm (RFF) flaps, offers reliable and functional restoration in one surgery.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Scalp defect reconstruction presents unique challenges due to tissue properties and limited adjacent tissue availability.
  • The standard reconstructive ladder is often difficult to apply to scalp defects, necessitating advanced techniques.

Purpose of the Study:

  • To review current reconstructive options for scalp defects.
  • To provide evidence-based recommendations for scalp restoration.
  • To highlight the role of microvascular free tissue transfer.

Main Methods:

  • Literature review of reconstructive techniques for scalp defects.
  • Analysis of the efficacy and outcomes of various free tissue transfer methods.
  • Evaluation of specific flap options, including latissimus dorsi, anterolateral thigh (ALT), and radial forearm (RFF) flaps.

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Main Results:

  • Microvascular free tissue transfer is a reliable mainstay for scalp reconstruction, offering good cosmetic and functional outcomes.
  • The latissimus dorsi, ALT, and RFF free flaps are the most frequently utilized options.
  • Advances in surgery and anesthesia have expanded patient candidacy for free tissue transfer.

Conclusions:

  • Microvascular free tissue transfer provides effective, well-tolerated, and aesthetically pleasing scalp restoration in a single operative procedure.
  • The latissimus dorsi, ALT, and RFF flaps are key reconstructive options for complex scalp defects.