Abstract
Scalp soft tissue reconstruction aims to tension free and durable coverage, especially in areas where calvarium is exposed. Extensive soft tissue defects of the scalp with exposed calvarial bone require flap and often microsurgical reconstruction to reliably cover the bone and prevent wound breakdown, osteomyelitis, repeated operations, and patient distress.
A sizeable soft issue defect, as a result of a full thickness burn of the scalp, reconstructed with anterolateral thigh free flap is presented. The flap pedicle was anastomosed with the superficial temporal vessels, which had preoperatively been evaluated to be appropriate as a recipient system.
The anterolateral thigh flap provided relatively thin skin to adequately and reliably cover the extensive scalp soft tissue defect. The flap can be harvested simultaneously with wound debridement and the preparation of the recipient vessels. Furthermore, it contours nicely to the skull and is associated with minimal donor site morbidity.
Recovery was uneventful and, despite reconstruction with non-hair bearing skin, the aesthetic outcome was satisfactory.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Beasley NJ, Gilbert RW, Gullane PJ, Brown DH, Irish JC, Neligan PC. Scalp and forehead reconstruction using free revascularised tissue transfer. Arch Facial Plast Surg. 2004;6:16–20.
Cormack G. Anterolateral thigh flap: technical tip to facilitate elevation. Br J Plast Surg. 1992;45:74.
Gravvanis A, Karakitsos D, Dimitriou V, Zogogiannis I, Katsikeris N, Karabinis A, Tsoutsos D. Portable duplex ultrasonography: a diagnostic and decision-making tool in reconstructive microsurgery. Microsurgery. 2010;30:348–53.
Gravvanis A, Tsoutsos D, Delikonstantinou I, Dimitriou V, Katsikeris N, Karakitsos D. Impact of portable duplex ultrasonography in head and neck reconstruction. J Craniofac Surg. 2012;23:140–4.
Hamilton JB. Patterned loss of hair in man: types and incidence. Ann N Y Acad Sci. 1951;53:708–28.
Hansen SL, Foster RD, Dosanjh AS, Mathes SJ, Hoffman WY, Leon P. Superficial temporal artery and vein as recipient vessels for facial and scalp microsurgical reconstruction. Plast Reconstr Surg. 2007;120:1879–84.
Heitmann C, Guerra A, Metzinger SW, Levin LS, Allen RJ. The thoracodorsal artery perforator flap: anatomic basis and clinical application. Ann Plast Surg. 2003;51:23–9.
Kimata Y, Uchiyama K, Ebihara S, et al. Anterolateral thigh flap donor-site complications and morbidity. Plast Reconstr Surg. 2000;106:584–8.
Koshima I, Fukuda H, Utunomiya R, Soeda S. The anterolateral thigh flap; variations in its vascular pedicle. Br J Plast Surg. 1989;42:260–3.
Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg. 2005;116:54e–72e.
Lin SJ, Hanasono MM, Skoracki RJ. Scalp and calvarial reconstruction. Semin Plast Surg. 2008;22:281–93.
Mashkevich G, Patel AD, Urken ML. Aesthetic management of external skin paddles following microvascular reconstruction of the head and neck. Facial Plast Surg. 2008;24:65–8.
Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;68:1359–65.
O’Reilly AG, Schmitt WR, Roenigk RK, Moore EJ, Price DL. Closure of scalp and forehead defects using external tissue expander. Arch Facial Plast Surg. 2012;14:419–22.
Ooi ASH, Kanapathy M, Ong YS, Tan KC, Tan BK. Optimising aesthetic reconstruction of scalp soft tissue by an algorithm based on defect size and location. Ann Acad Med Singap. 2015;44:535–41.
Pennington DG, Stern HS, Lee KK. Free-flap reconstruction of large defects of the scalp and calvarium. Plast Reconstr Surg. 1989;83:655–61.
Radovan C. Tissue expansion in soft-tissue reconstruction. Plast Reconstr Surg. 1984;74:482–92.
Wong CH, Wei FC. Anterolateral thigh flap. Head Neck. 2010;32:529–640.
Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck. 2004;26:759–69.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Kakagia, D.D., Gravvanis, A. (2022). Microvascular Reconstruction of Soft Tissue Defects of the Scalp. In: Gravvanis, A., Kakagia, D.D., Ramakrishnan, V. (eds) Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-23706-6_1
Download citation
DOI: https://doi.org/10.1007/978-3-030-23706-6_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-23705-9
Online ISBN: 978-3-030-23706-6
eBook Packages: MedicineReference Module Medicine