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Snail Flap for Scalp Reconstruction: Technique and Outcomes
Andrew M Peterson1,2, Nicholas A Rapoport3, Sarah N Chiang4
1Head and Neck Tumor Center at Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA.
Head & Neck
|January 17, 2025
Summary
The snail flap offers a reliable and easy method for scalp reconstruction, preserving hair with minimal complications. This technique is ideal for elderly patients with moderate scalp defects.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Dermatology
Background:
- Scalp reconstruction commonly utilizes local flaps, yet the snail flap remains under-documented.
- Limited literature exists on the efficacy and application of the snail flap for scalp defects.
Purpose of the Study:
- To detail the surgical technique of the snail flap for scalp reconstruction.
- To evaluate the outcomes and complication rates associated with the snail flap procedure.
Main Methods:
- A retrospective case series of 44 patients who underwent scalp reconstruction using the snail flap between January 2019 and February 2024.
- Assessment of flap complications, demographic data, and intra-operative variables.
- Primary outcome was the incidence and severity of complications.
Main Results:
- The study included 44 patients (median age 74 years) with scalp defects ranging from 3x3 cm to 8x8 cm.
- A 100% flap survival rate was achieved, with minimal complications including wound infections (20%), minor necrosis (27%), and hematoma (5%).
- Most procedures (91%) were performed in an outpatient setting or with overnight observation.
Conclusions:
- The snail flap is a highly reliable and straightforward technique for scalp reconstruction.
- It facilitates hair preservation and demonstrates minimal morbidity, making it suitable for elderly or frail patients.
- The procedure is an excellent option for moderate-sized scalp defects due to its low complication rate and minimal need for hospitalization.
