Novel skin graft donor site for the scalp transposition flap

Transposition scalp flaps are a versatile solution for soft-tissue cover in a multitude of scalp defects. They are frequently used to reconstruct larger skin cancers that involve the outer table of the cranium in addition to covering neurosurgical bony defects and hardware. The transposition flap requires the donor site to be grafted using a split-thickness graft, which results in a secondary wound elsewhere on the body, commonly the lateral thigh. Although quite routine in such surgery, this procedure does require another body area to be prepared and draped. We sought to streamline this procedure with an adjustment to the location of the donor site. In harvesting the graft from the skin of the flap itself, we localised all surgery to one area, which has a number of logistical and patient-care advantages. Our experience has shown significant benefits from this technique and this is now our chosen and recommended donor site for these reconstructions.