Scalp flap rotation with primary donor site closure

A 57-year-old man with a 7-cm defect of the left temple underwent reconstruction with a large scalp rotation flap that shifted the donor defect to the back of the neck so that it could be closed primarily. This approach, also used successfully in 7 other patients with similar defects, avoided the need for an unsightly skin graft in the donor site while providing tissue with a color and texture that blended well with the surrounding forehead and facial skin. Primary closure of the donor site reduces scalp flap morbidity and improves the overall aesthetic outcome.