Cadaveric Split-Thickness Skin Graft With Partial Guiding Closure for Scalp Defects Extending to the Periosteum

Area of Science:

• Plastic Surgery
• Wound Healing
• Regenerative Medicine

Background:

• Scalp defects extending below the periosteum present reconstructive challenges, often necessitating complex rotational flaps.
• Rotational flaps can complicate post-operative monitoring for tumor recurrence and pose risks for vulnerable patients.
• Optimizing wound healing and cosmetic outcomes requires alternative reconstructive strategies.

Purpose of the Study:

• To describe a technique utilizing cadaveric split-thickness skin grafts (STSGs) for scalp reconstruction.
• To demonstrate the utility of STSGs in promoting granulation and epithelialization in challenging wound scenarios.
• To highlight the benefits of STSGs in facilitating recurrence monitoring and managing complex patient populations.

Main Methods:

• Application of biologically active cadaveric split-thickness skin grafts (STSGs) to scalp defects.
• Utilizing STSGs in cases with compromised periosteum or concerns for delayed wound healing.
• Employing STSGs in oncologic reconstructions requiring clear post-operative surveillance.

Main Results:

• Cadaveric STSGs expedite granulation and epithelialization of scalp wounds.
• The technique provides a viable alternative to complex flaps, especially in high-risk patients.
• STSGs facilitate easier monitoring for tumor recurrence compared to rotational flaps.

Conclusions:

• Cadaveric STSGs are a valuable tool for reconstructing scalp defects involving periosteal exposure.
• This method enhances wound healing and simplifies post-operative surveillance in oncologic cases.
• The technique offers improved reconstructive options for patients with comorbidities or significant skin atrophy.