Reconstruction of scalp wounds with exposed calvarium using a local flap and a split-thickness skin graft: case series of 20 patients.

Journal Article

OBJECTIVES: To describe the design, execution, outcomes, and advantages of a combined flap and split-thickness skin graft reconstructive technique for the repair of wounds of the scalp with exposed bone after Mohs micrographic surgery. MATERIALS AND METHODS: An analysis of the combined flap and graft technique of 20 scalp defects ranging in size from 6.25 to 37.6 cm(2) is provided. Surgical defects and patient characteristics are described. Follow-up information is reviewed, and complications and final aesthetic results are reported. RESULTS: Twenty patients with 20 tumors on the scalp (16 squamous cell carcinoma, 2 basal cell carcinoma, 1 Merkel cell carcinoma, and 1 malignant fibrous histiocytoma) were treated using Mohs micrographic surgery. A combined flap and graft technique was successfully employed with good aesthetic outcomes in all 20 patients with broad scalp defects. One postoperative complication of approximately 20% skin graft necrosis was noted. One methicillin-resistant Staphylococcus aureus postoperative wound infection occurred but resolved without sequelae with appropriate antibiotic treatment. CONCLUSION: The described flap and graft reconstructive technique is a reproducible, one-stage procedure for the reconstruction of medium to large scalp defects with exposed bone, obviating the need for more-complicated, costly, time-consuming procedures. LIMITATIONS: Small sample size, descriptive study.

Full Text

Duke Authors

Cited Authors

  • Aldabagh, B; Cook, JL

Published Date

  • March 2014

Published In

Volume / Issue

  • 40 / 3

Start / End Page

  • 257 - 265

PubMed ID

  • 24438208

Electronic International Standard Serial Number (EISSN)

  • 1524-4725

International Standard Serial Number (ISSN)

  • 1076-0512

Digital Object Identifier (DOI)

  • 10.1111/dsu.12412

Language

  • eng