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Immediate total scalp and skull reconstruction.
Microsurgery
|January 1, 1983
Summary
Reconstruction of large scalp, bone, and dura defects after basal cell carcinoma excision was achieved using a latissimus dorsi flap, titanium, and fascia. This multi-layer approach yielded excellent cosmetic and functional outcomes for the patient.
Area of Science:
- Plastic Surgery
- Craniofacial Reconstruction
- Oncologic Reconstruction
Background:
- Basal cell carcinoma (BCC) can necessitate extensive resection, leading to significant scalp, bone, and dural defects.
- Reconstructing large, multi-layered defects presents a complex surgical challenge.
Observation:
- A patient presented with a large scalp defect (23 cm x 23 cm) following BCC excision.
- Associated defects included an 18 cm x 16 cm bony defect and a similar dural defect.
Findings:
- Simultaneous, three-layer reconstruction was performed using a free latissimus dorsi flap, titanium strips for bony defect coverage, and lumbar fascia for dural repair.
- This combined technique successfully addressed the scalp, bony, and dural defects.
Implications:
- The described multi-modal reconstructive technique offers a viable solution for extensive craniofacial defects.
- This approach can achieve satisfactory cosmetic and functional results in complex oncologic reconstruction cases.