Reconstruction of Scalp and Forehead Defects: Options and Strategies

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Aesthetic Reconstruction

Background:

• Aesthetic reconstruction of scalp and forehead defects is crucial.
• Local flaps are preferred for minimal donor site morbidity.
• Factors influencing technique selection include defect size, location, and tissue components.

Purpose of the Study:

• To evaluate the outcomes of various reconstructive techniques for scalp and forehead defects.
• To determine the most effective methods based on defect characteristics.
• To assess aesthetic results and postoperative complications.

Main Methods:

• Retrospective analysis of 54 patients with scalp and forehead defects.
• Defect size categorized into small (<4 cm²), medium (4-50 cm²), large (50-200 cm²), and very large (>200 cm²).
• Reconstruction techniques included primary closure, local flaps (rotation, transposition), skin grafting, and free tissue transfer.

Main Results:

• Trauma was the most common etiology (29.6%).
• Rotation flaps and primary closure were most frequent (22.2% each).
• Excellent aesthetic outcomes were observed with primary closure and rotation flaps.

Conclusions:

• Local flaps provide superior aesthetic results due to similar architecture and low donor site morbidity.
• Scalp defects up to 50 cm² were managed with local flaps and primary closure.
• Larger defects (50-200 cm²) required local flaps with skin grafting; very large or complex defects necessitated free tissue transfers.