A staged approach for complex scalp defects using titanium mesh and anterolateral thigh flaps: Two case reports.

Area of Science:

• Oncology
• Plastic Surgery
• Head and Neck Surgery

Background:

• Scalp tumors, including invasive squamous cell carcinoma and sarcomas, present unique challenges due to their aggressive nature and potential for extensive tissue destruction.
• Large resections of these neoplasms often result in full-thickness scalp defects, posing significant reconstructive difficulties.

Observation:

• This study details a staged reconstructive approach for complex scalp defects.
• The technique involves the use of titanium mesh for structural support followed by microvascular free tissue transfer, specifically utilizing the anterolateral thigh (ALT) flap.

Findings:

• The anterolateral thigh free flap demonstrated predictable and successful outcomes in reconstructing significant scalp and calvarial defects.
• This method proved safe and reliable for complex cases requiring both soft tissue and bony coverage.

Implications:

• The findings highlight the efficacy of free flap reconstruction in managing challenging scalp defects, particularly in resource-limited settings where microsurgical expertise is available.
• This approach offers a viable option for restoring both function and aesthetics in patients with extensive oncological resections of the head and neck.