Reconstruction of Scalp with Local Axial Flaps

Gupta, Pradeep Kumar; Srivastava, Saket

doi:10.1007/s12070-020-02103-5

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…Regarding surgical method of reconstruction, Bas et al [5] used flaps musculocutaneous latissimus dorsi [LD] in 4 cases, LD muscle in 3 cases, anterolateral thigh [ALT] in 4 cases, musculocutaneous ALT in one case, vastus lateralis muscle in one case, and rectus abdominis muscle in one case. [17] used trans-position flap in 36 cases, Rotation advancement flap in 11 cases, double hatchet flap in 2 cases, bipedicle flap in 2 cases, double transposition in 3 cases.…”

Section: Discussionmentioning

confidence: 99%

“…95% CI of rate [%] Bas et al [5] 14 14 100.0 76.840-100.0 Del Castillo et al [9] 30 30 100.0 88.430-100.0 Chaiyasate et al [10] 13 13 100.0 75.295-100.0 Aronson and Ellis [11] 9 8 88.889 51.750-99.72 Jang et al [12] 94 6 6.383 2.378-13.38 Tecce et al [13] 189 164 86.772 81.096-91.25 Chen et al [14] 8 8 100.0 63.058-100.0 Shin et al [15] 2 2 100.0 15.811-100.0 Ehrl et al [16] 38 34 89.474 75.195-97.06 Gupta and Srivastava [17] 54 54 100.0 93.397-100.00 Zhou et al [18] 1 1 100.0 2.500-100.0 Weitz et al [19] 17 15 88.235 63.559-98.54 Wolff et al [20] 33 31 93.939 79.774-99.26 Kim et al [21] 1 0 0.0 0.000-97.50 Lamaris et al [ 95% CI of rate [%] Bas et al [5] 14 1 7.143 0.181-33.868 Del Castillo et al [9] 30 2 6.667 0.818 -22.074 Aronson and Ellis [11] 9 1 11.111 0.281 -48.250 Jang et al [12] 94 1 1.064 0.0269 -5.785 Tecce et al [13] 189 48 25.397 19.358 -32.225 Chen et al [14] 8 2 25.000 3.185 -65.086 Gupta and Srivastava [17] 54 2 3.704 0.452 -12.747 Zhou et al [18] 1 1 100 2.500 -100.0 Weitz et al [ [16] 38 3 7.895 1.659 -21.377 Gupta and Srivastava [17] 54 2 3.704 0.452 -12.747 Zhou et al [18] 1 0 0.000 0.000-97.50 Lamaris et al [ 95% CI of rate [%] Jang et al [12] 94 3 3.191 0.663 -9.045 Ehrl et al [16] 38 4 10.526 2.943 -24.805 Gupta and Srivastava [17] 54 0 0.000 0.000 -6.603 Zhou et al [18] 1 0 0.000 0.000 -97.500 Weitz et al [19] 17 2 11.765 1.458 -36.441 Wolff et al [20] 33 2 6.061 0.743 -20.226 Kim et al [21] 1 1 100.0 2.500 -100.000 Lamaris et al [22] 14…”

Section: Event Event Rate [%] [Proportion]mentioning

confidence: 99%

“…As regard healing rate, the pooled analysis of the included studies showed that the mean healing rate was 86.495%. Healing was reported by 15 studies [5,[9][10][11][12][13][14][15][16][17][18][19][20][21][22] with major heterogeneity between studies.…”

Section: Gupta and Srivastavamentioning

confidence: 99%

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Reconstruction of Scalp Defects: A Meta-Analysis Study

Ali

Ahmed

Omran

2023

International Journal of Medical Arts

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Article informationBackground: Scalp deficiencies can be caused by a number of different etiological reasons, including tumor extirpation, infection, burns, or trauma to this special region of the human body. The scalp can be reconstructed in a number of ways, including through primary closure, skin grafting, local flaps, tissue expansion, or free tissue transfer. Aim of the work:To evaluate the various methods utilized for reconstructing scalp deformities; to get better surgical choice, through meta-analysis regarding defect size, depth, location, hair line, alopecia risk and aesthetic appearance.Patients and Methods: Recent clinical trials or cluster trials, as well as retrospective compared cohort studies, were included in this Metaanalysis. Study was conducted on human subjects with reconstruction of scalp defects. Review of the Methods Used in Reconstructing Scalp Defects; to get better surgical choice, through meta-analysis regarding defect size, depth, location, hairline, alopecia risk and aesthetic appearance.Results: A total of 393 cases had complete healing as regard complications founded in form of Hematoma in 18 cases, infection in 4 cases, seroma in 3 cases, wound dehiscence in 63 cases, Distal flap necrosis in 1 case, Partial flap loss in 13 cases, total Graft loss in 13 cases. Conclusion:Using local flaps to repair scalp abnormalities is a straight forward operation that does not often require extensive postoperative care and can be completed in a short amount of time with minimal risk. A local scalp flap is the preferred method for reconstructing even a big and complex scalp defect, such as one that involves the cranium or the dura. Our findings suggest that problems from local axial flap applications were infrequent and did not significantly impact flap survival.

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Section: Discussionmentioning

confidence: 99%

Section: Event Event Rate [%] [Proportion]mentioning

confidence: 99%

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Reconstruction of Scalp Defects: A Meta-Analysis Study

Ali

Ahmed

Omran

2023

International Journal of Medical Arts

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“…To minimize the formation of scars in the folds, one edge of the scar is obliquely sectioned, and in the opposite direction, the other edge. In hair-covered regions, such as the scalp, serial excisions are recommended, using triangulation, which allows the edges of the wound to approach, while minimizing the excision of healthy scalp skin [ 17 ].…”

Section: Surgical Techniques Used To Reduce Scarsmentioning

confidence: 99%

“…This angle determines the degree of elongation of the tissue, the greater the angle, the more length is gained. An angle of 60º in Z-plasty represents a 75% gain in tissue length and changes the direction of the scar by 90º [ 17 ]. An angle of 30º lengthens the scar by 25%, an angle of 45º by 50%, an angle of 75º by 100%, and an angle of 90º, lengthens by 125%.…”

Section: Surgical Techniques Used To Reduce Scarsmentioning

confidence: 99%

Surgical scar management - an evaluation of surgical techniques

Căiță,

Lascu,

Bodog

et al. 2024

Medicine and Pharmacy Reports

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The purpose of this narrative review is to analyze surgical techniques for removing scar tissue and minimizing them. A considerable proportion of the population have scars that are related to a traumatic event that they remember accurately, this being especially true for scars on the face, but also on the rest of the body if they are of significant size. The negative consequences of the esthetic damage are felt mainly in the family and at professional level, without losing sight of the fact that any person suffers as a result of the awareness of unsightly wounds or scars. To be successful, an aesthetic intervention must represent the optimal balance between science, the art of plastic surgery and the patient’s expectations. Good communication between surgeon and patient is also needed. We must state that there is no method of total removal of scars; even in the case of complex surgical techniques, the scar cannot be completely excised, but a much more aesthetic appearance can be obtained. Scars cannot be completely removed from the skin, they can improve their appearance by fading or thinning, initially by conservative treatment, later, if necessary, by surgical scar reduction techniques. Improving the appearance of a scar depends on the type of scar, its severity, its surface and location, the causing factors, the time elapsed from production to the application of specialized treatment.

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Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

Aufschnaiter-Hiessboeck,

Stefanits,

Rossmann

et al. 2024

Acta Neurochir

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Background and objectives Although rare, complications like skin dehiscence and necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to the epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims to assess the prior clinical courses, neuroplastic repair, and outcomes of patients with skin defects following cranial neurosurgical procedures, and to outline our interdisciplinary reconstructive protocol. Methods A retrospective analysis was performed on cranial surgeries conducted at the Department of Neurosurgery, spanning from 2017 to 2023. Patients with skin defects requiring the combined expertise of neurosurgery and plastic surgery for effective treatment were included. The sizes of the skin defects were measured using intraoperative photographs analyzed with the freeware ImageJ software, version 2018. All patients provided informed consent for the surgeries. If informed consent was not possible due to neurological deterioration, consent was sought from adult representatives or next of kin except for acute circumstances. All patients admitted to our hospital agree to the pseudonymized use of their medical data and tissue specimens for research purposes in their treatment contract. Results A cohort of 24 patients experiencing wound healing complications after neurosurgical procedures underwent a total of 29 interdisciplinary surgeries for the reconstruction of skin, dural, and bone defects. After the neuroplastic surgery, 8 out of 24 patients (33.3%) developed surgical complications, with 6 of these requiring revision surgeries due to persistent cranial infection. In all cases, permanent wound closure was successfully achieved following adherence to the proposed treatment algorithm. Conclusions Our study underscores the necessity of an integrated neurosurgical and plastic surgical approach to effectively manage wound healing complications in a single stage surgery. Key interventions include differentiation between necrosis and gaping lesions, alongside precise management of neurosurgical issues like cerebrospinal fluid fistulas and hydrocephalus. Plastic surgical expertise in assessing the possibilities and limitations of both local and free flap surgeries is essential.

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Reconstruction of Scalp with Local Axial Flaps

Cited by 7 publications

References 23 publications

Reconstruction of Scalp Defects: A Meta-Analysis Study

Reconstruction of Scalp Defects: A Meta-Analysis Study

Surgical scar management - an evaluation of surgical techniques

Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

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