Dual transposition flaps for the reconstruction of large scalp defects

Fincher, Edgar F.; Gladstone, Hayes B.

doi:10.1016/j.jaad.2009.01.009

Cited by 12 publications

(7 citation statements)

References 15 publications

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“…Striving for simplicity, this would be favorable to using a single large scalp rotational flap and a skin graft to close the donor site. [3][4][5] V-Y advancement flaps most often are used to treat scalp defects of small-to-medium size [5][6][7] and have been used for larger defects of the scalp, 5,6 which requires a large amount of surrounding scalp involvement and long incisions, thus creating excess scarring. With larger scalp defects, the V-Y advancement flap must become thinner and longer to distribute the tension over a larger area.…”

Section: Discussionmentioning

confidence: 99%

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Double-Opposing Unilobar Rotation Flaps in the Reconstruction of Moderate-to-Large Defects of the Scalp

Moulton-Barrett

Vanderschelden²

2015

Journal of Craniofacial Surgery

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Closure of medium-to-large-size defects of the scalp are often associated with unacceptable aesthetic results, wound break down, alopecia, and excessive scarring. The authors present 2 cases of double-opposing unilobar rotation flaps for the reconstruction of large, that is, at least 7 cm diameter, full thickness defects of the scalp. Unlike previously described double flap closures of scalp defects, the double-opposing unilobar rotation flap design are true rotation flaps, which require a Burow triangle excisions and which have a versatility in both width and length of design to accommodate closure of large defects of the scalp. Some of the advantages of this technique are the retention of hair-bearing skin without distortion of the follicle position, an aesthetically pleasing scar, minimal tension at the wound closure site, and the versatility as well as simplicity of the technique.

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Section: Discussionmentioning

confidence: 99%

“…4 Pivoting of the base is often associated with distortion of scalp contour and may lead to a larger donor deficit. Swinging almost 908 also disrupts the hair orientation of the surrounding scalp and for larger scalp defects requires a 2-stage closure.…”

Section: Discussionmentioning

confidence: 99%

Double-Opposing Unilobar Rotation Flaps in the Reconstruction of Moderate-to-Large Defects of the Scalp

Moulton-Barrett

Vanderschelden²

2015

Journal of Craniofacial Surgery

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“…This technique is particularly valuable for the repair of defects involving the hairline but requires undermining of a significant portion of the scalp. Recently, a single case report showed a delayed two‐stage dual transposition flap to be capable of closing a large scalp defect, providing another elegant repair option for large scalp defects 10 …”

Section: Discussionmentioning

confidence: 99%

“…Recently, a single case report showed a delayed two-stage dual transposition flap to be capable of closing a large scalp defect, providing another elegant repair option for large scalp defects. 10 Skin grafting is another method for reconstruction of scalp defects, 1 but a skin graft will almost always result in alopecia in hair-bearing scalps, and in alopecic scalps, skin grafts often heal with a visible white patch. Finally, secondary-intention healing can be considered for the scalp, 11 although, in our experience, scalp defects often heal slowly by second intention, which is often too burdensome for the patient.…”

Section: Discussionmentioning

confidence: 99%

Repair of Scalp Defects Using an H-Plasty Type of Bilateral Advancement Flap

Ibrahimi

Jih

Aluma-Tenorio

et al. 2010

Dermatologic Surgery

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Sixty-nine 1.5- to 3.0-cm-diameter scalp defects resulting from Mohs micrographic surgery that could not be closed primarily were identified over the 2-year study period. All 69 defects were closed entirely with the bilateral advancement flap, and there were no significant complications. CONCLUSIONS; The H-plasty type of bilateral advancement flap allows appropriately selected scalp defects that might not be readily closed primarily to be repaired easily using local skin, providing an attractive alternative to other flap techniques, skin grafting, and healing via secondary intention. The limitations of this study are that the results are based on a retrospective single-surgeon experience and that there was no long-term follow-up scheduled to evaluate the final cosmetic outcome of the repair.

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“…1 Local flaps include V-Y advancement flaps, transposition flaps and rotation flaps, and each technique should be chosen based on location, hair follicle geography and the quality of the remaining scalp. 4,5 This is a well-established concept and works well for scalp defects. However, this is not true for hair whorl defects because even primary closure results in interruption of hair flow and aesthetic dissatisfaction.…”

mentioning

confidence: 99%