Flaps and Grafts Reconstruction

Management of a complex scalp defect with cryopreserved placental membrane containing viable cells resulted in rapid wound closure

“…Two commonly used reconstructive methods for scalp wounds postexcision are flaps and skin grafts. Split‐thickness skin grafts (STSG), specifically, are often used for large surgical defects and defects with a high risk of tumor recurrence when a wound cannot be closed by primary intention . During the harvesting of a skin graft, its vascular supply is also separated.…”

“…These are single‐stage treatment options that are not as heavily dependent on vascularity of the recipient site as skin grafts. These procedures, however, can be associated with significant donor‐site morbidity and longer operative times making them not feasible for patients with significant comorbidities and advanced age that may not be suitable for surgery …”

“…Reconstructive methods are most commonly used to treat scalp defects with the aim to provide vascularized soft tissue coverage of the defect and to achieve positive cosmetic outcomes. Local and distant skin flaps and free tissue transfer are often used to cover these defects which is necessary to avoid delayed wound healing and also reduces pain and risk for complications such as osteomyelitis . However, patients with complex defects are often not good candidates for surgical procedures due to the severity of the wound, advanced patient age, and additional health conditions that may decelerate the normal wound healing process.…”

Fractional epidermal skin grafting

“…Skin grafts can be obtained from several sources, both human and animal. Skin grafts can include all or a portion of the skin, including the epidermis and dermis . More recently, the use of skin substitutes, dermal fillers and tissue expanders has increased surgeons' and dermatologists' ability to cover skin defects resulting from burns, traumatic injury, chronic wounds or excision of cancerous lesions .…”

Fractional Skin Harvesting

“…Skin wounds that are too extensive to heal by primary closure often require reconstruction by autologous grafting or flap transplantation, 1 which in turn requires harvesting of donor skin, causing morbidities—including pain, risk of infection, discoloration, and scarring—that are frequently more troublesome for patients than the primary wounds themselves. 2,3 Split-thickness skin grafting (STSG), the current “gold standard” for closing large skin wounds, 4 involves harvesting the epidermis and the upper portion of dermis from donor sites, and then transplanting the grafts onto the wound(s).…”