Rotation-advancement flaps as a reliable reconstruction procedure in large scalp defects

Introduction:

The reconstruction of the scalp after wide tumor excision requires can be challaging due to the lack of elasticity of the tissue. Cosmetic most favorable is the primary closure, which is only possible in small or midsize defects. A defect closure with microvascular anastomosed grafts is complex and may be associated with morbidity.

Methods:

For this descriptive retrospective study, we reviewed the management of all patients who received a defect closure of the scalp using rotation-advancement flaps (RAF), within the last five years. Demographic and clinical data were obtained from patient records and analyzed with respect to defect size, extent of rotational plasty, duration of surgery, duration of wound healing and local tumor control.

Results:

20 patients with scalp defect reconstruction using different RAFs were detected (simple + opposite (os) RAF, n = 8; "Windmill-plasty" (WP), n = 12). The average defect size was 10.3 (± 4.5)cm² for the osRAFs and 22.6 (± 7.2)cm² for the WPs. The average duration of surgery was 60 (± 21)min for the osRAFs and 92.4 (± 32.4)min for the WPs. The duration of wound healing was 2.1 (± 0.3) weeks for the osRAFs and 4.6 (± 3.7) weeks for the WPs. Over a follow-up period of 27.6 (± 19.6) months, there was no local recurrence in all cases.

Conclusion:

Rotation-Advancement Flaps represent a reliable procedure for scalp reconstruction even for larger defects, associated with moderate surgical duration and acceptable wound healing time.

Publication History

Publication Date:
18 April 2018 (online)