The subgalea-periosteal turnover flap for reconstruction of scalp defects

Subgalea-periosteal flaps were successfully used in a turnover pattern to reconstruct two scalp defects with exposed calvaria caused by tumor ablation. A copious vascular network of the subgaleal fascia in the base and its attached lateral territories provide adequate blood inflow for the turnover flap. The periosteum is included in the flap to protect the blood supply of the subgaleal component from damage during dissection, and its uniform surface constitutes an ideal bed to receive skin grafts. The tissue is readily available and a large flap can be created in a single surgical step without deformities or sequelae left in the donor area. The subgalea-periosteal turnover flap overlaid with skin graft seems to make reconstruction of the complicated scalp defect much simpler and straightforward.