Reconstruction of the Wide Scalp Defects Using Free Latissimus Dorsi Flap Assisted With Arteriovenous Loop

Reconstructions of the wide scalp defects are still a challenging task because of the accompanied recipient vessel issues. Arteriovenous loop (AVL) grafts are a suitable vascular conduit that can be used to support free tissue transfer, when adjacent blood supply is inadequate. We report 2 patients of successful wide scalp reconstruction, using a free latissimus dorsi (LD) flap assisted with AVL. Both flaps and AVL grafts fully survived postoperatively. No complications related to the recipient and donor areas developed. The flaps obtained a durable barrier and an acceptable aesthetic appearance. We believe that AVL can be a useful adjunct for increasing the success rate of wide scalp reconstructions with inadequate adjacent arterial inflow or venous outflow. The free LD flap is a good option with its wide surface, rich vascularity and relatively low donor morbidity in such reconstructions.