Temporoparietal Fasciocutaneous Island Flap for Forehead and Anterior Scalp Reconstruction

Background: Forehead and anterior scalp large defect reconstruction is challenging and often requires skin grafting. Objective: To measure the advancing distance and the survival of the temporoparietal fascia (TPF) island flap in forehead and anterior scalp reconstruction. Methods: The study design was a retrospective case series. Participants included all patients who had undergone TPF island flap for forehead and anterior scalp defects of 3 cm and greater from 2009 to 2021. Flap advancing distance and vascular compromise were analyzed. Results: Patient's average age at time of surgery was 73 (standard deviation [SD] 14) years with more males (n = 24, 67%) than females (n = 12, 33%). Of 36 patients, 24 had forehead and 12 had anterior scalp defects, 26 cases had a full TPF island flap, and 10 cases underwent the partial island modification. Flap edge ischemia occurred in two cases (6%) and complete ischemia occurred in one case (3%). The median flap advancing distance was 3.7 cm (SD 1.2). Conclusions: In this 12-year review, we found that the TPF island flap is able to advance up to 7.5 cm and thus is an effective reconstruction for medium to large forehead and anterior scalp defects.