Microsurgical Scalp Reconstruction: An Overview of the Contemporary Approach.

Area of Science:

• Plastic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Microsurgical scalp reconstruction has advanced significantly over 50 years.
• Key goals include quality soft tissue transfer and minimized donor site morbidity.
• Improvements focus on reducing donor site issues and enhancing recipient site aesthetics.

Purpose of the Study:

• To describe the contemporary approach to microsurgical scalp reconstruction.
• To outline indications and selection criteria for free flaps.
• To review recipient vessel selection, operative techniques, and reoperations.

Main Methods:

• Review of current literature and clinical practices in microsurgical scalp reconstruction.
• Analysis of patient-oriented factors for ideal flap selection.
• Discussion of nuances in cranioplasty, vessel selection, and surgical technique.

Main Results:

• Free flaps, specifically anterolateral thigh perforator and latissimus dorsi muscle flaps, are primary options.
• Preoperative evaluation of recipient vessels is crucial for favorable outcomes.
• Successful reconstruction requires individualized application of plastic surgery principles.

Conclusions:

• Microsurgical scalp reconstruction demands a comprehensive, case-specific approach.
• Anterolateral thigh perforator and latissimus dorsi flaps are essential tools.
• This review provides a foundation for future advancements in complex scalp reconstruction.