Reliable Outcomes of Free Fasciocutaneous Flaps for Complex Oncologic Scalp Reconstruction: A Multicenter Comparative...

Area of Science:

• Microsurgery
• Plastic Surgery
• Oncology

Background:

• Oncologic scalp reconstruction presents significant challenges, often requiring free flaps for extensive defects, cranioplasty, and radiotherapy.
• Musculocutaneous flaps are traditional, but fasciocutaneous flaps are increasingly used, with unclear safety in high-risk scenarios.

Purpose of the Study:

• To compare the outcomes of musculocutaneous versus fasciocutaneous flaps in oncologic scalp reconstruction.
• To evaluate flap safety and efficacy in complex reconstructive settings.

Main Methods:

• Retrospective review of 109 patients undergoing microsurgical scalp reconstruction for oncologic defects (2018-2024).
• Patients were divided into musculocutaneous and fasciocutaneous flap cohorts.
• Comparison of postoperative complication rates across different clinical settings.

Main Results:

• No significant difference in overall or specific complication rates between flap types.
• Musculocutaneous flaps showed more late complications (>3 months).
• Flap type did not independently predict complications on multivariable analysis.

Conclusions:

• Both flap types are effective for oncologic scalp reconstruction.
• Fasciocutaneous flaps are a reliable alternative, even in complex cases involving radiotherapy, cranioplasty, or extensive defects.