Single-Stage Repair of Complex Scalp and Cranial Defects with the Free Radial Forearm Flap

Chicarilli, Zeno N.; Ariyan, Stephan; Cuono, Charles B.

doi:10.1097/00006534-198604000-00010

Cited by 60 publications

(13 citation statements)

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“…[1][2][3] Flaps commonly used for scalp and calvarial reconstruction are the latissimus dorsi, 4 omentum, 5 rectus abdominis, 6 and the radial forearm free flap. 7 The diversity of flaps utilized in craniofacial reconstruction implies that each of them has its own indications, advantages, and disadvantages. The anterolateral thigh flap was first described by Song et al 8 in 1984 as a fasciocutaneous flap.…”

mentioning

confidence: 99%

Free Anterolateral Thigh Flap for Reconstruction of Major Craniofacial Defects

Amin

Rifaat

Civantos

et al. 2006

J reconstr Microsurg

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Free-tissue transfer has revolutionized skull-base surgery by expanding the ability to perform cranial base resection and by improving the quality of reconstruction. The anterolateral thigh flap has come recently into use in the field of head and neck reconstruction. Its role in craniofacial and midface reconstruction has not been specifically defined. This study involved a total of 18 patients who were treated over a 5-year period from 1998 to 2003. Seventeen patients had locally advanced head and neck cancer, requiring craniofacial resection, and one patient had a complicated gun shot wound of the forehead. Thirteen patients were treated at the National Cancer Institute, Cairo University, Egypt, and five patients at the University of Miami, Florida. The patients presented with defects of the anterior skull base (5), lateral skull base (3), scalp and calvarium (3), and the midface (7). The anterolateral thigh flap was used as a myocutaneous flap in 11 cases and as a perforator fasciocutaneous flap in seven cases. Musculocutaneous perforators supplied the majority of flaps (17/18). Total flap survival occurred in 17 cases; one patient developed complete flap necrosis. The most commonly used recipient vessels were the facial vessels and the external jugular vein. Major complications included one case with meningitis; the patient died after failure of treatment. Another patient died 6 weeks postoperatively from pulmonary embolism. One patient developed CSF leak that stopped spontaneously. In addition, two patients developed minor wound dehiscence that healed spontaneously. The donor-site wound healed without problems except in two cases. One patient had an incomplete take of the skin graft; the other developed wound infection and superficial sloughing. Both wounds healed spontaneously. In addition to the feasibility of simultaneous flap harvesting with tumor resection, the flap's advantage in skull base reconstruction is its reliable blood supply, which can provide adequate dural cover and protection of the brain. Its size and moderate thickness are suitable for reconstruction of scalp and calvarial defects. The abundance of reliably vascularized fat in the flap may be an advantage in long-term maintenance of the volume of the flap in midface reconstruction. Similar to other soft tissue flaps, additional skeletal reconstruction may still be required to achieve an optimal functional and aesthetic result.

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mentioning

confidence: 99%

Free Anterolateral Thigh Flap for Reconstruction of Major Craniofacial Defects

Amin

Rifaat

Civantos

et al. 2006

J reconstr Microsurg

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“…But, the long operative time, need of resources for these flaps is limitation. Hence, as for as possible, local tissues should be used for reconstruction of scalp [7,8]. Anatomically, scalp being highly vascular designing a flap and survival of flap is relatively better compared to other areas of body.…”

Section: Discussionmentioning

confidence: 99%

Scalp Rotation Flap-Minor Changes Major Gains

Manjunath¹,

Venkatesh²,

Vishwanath³

2017

Anaplastology

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“…Recently, in the reconstruction of soft tissue defects, free tissue transfer have been preferred [1,2,[4][5][6][9][10][11][12]. In repairing large scalp defects with free tissue transfer, latissimus dorsi myocutaneous or muscle radial forearm fasciocutaneous, omentum, groin, serratus anterior, rectus abdominis or a combination of these free flaps are used.…”

Section: Discussionmentioning

confidence: 99%