The Role of Pedicled Latissimus Dorsi Flap in Scalp Defect Reconstruction Following Tumour Excision

Ranjan, Kunal; Venkataramu, Vinay; Achanti, Hari Prasad; Khemka, Shruti; Shenoy, Ashok M.; Dandekar, Mitali

doi:10.1007/s12070-020-02071-w

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…5 Typically used as a pedicled flap in breast and trunk reconstruction, 6 it has been occasionally used to reconstruct scalp defects after oncological excision. 7,8 Jeong et al 7 covered a large scalp defect in one patient after tumor excision. Ranjan et al 8 used a pedicled myocutaneous LD flap for scalp reconstruction in three patients following tumor excision.…”

Section: Discussionmentioning

confidence: 99%

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Pedicled Latissimus Dorsi Flap for Extensive Scalp Reconstruction in Acute Burns

Alessandri-Bonetti,

David,

Egro

2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Extensive full-thickness head and neck burn defects represent some of the greatest challenges because of the exposure of burned calvaria and lack of good local reconstructive options. This study reports the use of a pedicled latissimus dorsi (LD) muscle flap to cover a large full-thickness scalp burn defect measuring 20 × 15 cm, including 15 × 13.7 cm of bone exposure and extending from the posterior neck to the mastoid and vertex of the scalp. The authors discuss the technique to safely maximize the reach, which includes distal dissection to the iliac crest and thoracolumbar fascia, dissection of the pedicle to the axillary vessels, tunnel creation through the pectoralis major muscle, re-attachment of the LD origin to the pectoralis major and teres major, and undermining of the neck skin and subcutaneous tissue to avoid damage of the accessory nerve. This case highlights the reach of a pedicled LD muscle flap for extensive scalp reconstruction for defects all the way to the vertex and beyond. The size and reliability of the LD muscle makes it a valuable alternative for large scalp defects for cases of complex scalp reconstruction in patients deemed not ideal candidates for free flap reconstruction.

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Section: Discussionmentioning

confidence: 99%

“…7,8 Jeong et al 7 covered a large scalp defect in one patient after tumor excision. Ranjan et al 8 used a pedicled myocutaneous LD flap for scalp reconstruction in three patients following tumor excision.…”

Section: Discussionmentioning

confidence: 99%

Pedicled Latissimus Dorsi Flap for Extensive Scalp Reconstruction in Acute Burns

Alessandri-Bonetti,

David,

Egro

2023

Plastic and Reconstructive Surgery - Global Open

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Scalp Reconstruction following Excision of Malignant Tumors in Southeastern Nigeria

Okwesili,

Achebe,

Onumaegbu

et al. 2023

Nigerian Journal of Medicine

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Background: Malignant scalp tumors are not common and constitute a small percentage of all scalp tumors. Reconstruction of the scalp defects following oncological resection presents peculiar challenges. Aim: The aim of the study is to report our experience in reconstructing scalp defect of varying sizes after the excision of malignant tumours using a variety of techniques. Materials and Methods: This was a retrospective review of patients who had scalp reconstruction after oncological resections from June 2010 to May 2014 (four years) at our teaching hospital in the South-east of Nigeria. Data on the demographics, nature of the scalp tumors, site, size of the defects, mode of scalp reconstruction, and outcomes were collected and analyzed. Results: Of the 17 patients who had scalp reconstruction, 29.4% of them were men and 70.6% were women (M:F = 5:2). The mean age of the patients was 41.2 ± 4.98 years (range: 19–85 years). The majority of the patients (47.1%) were young adults between 20 and 40 years, and the least involved age group (11.8%) was 13–19 years. The most common etiology of malignant scalp tumors was squamous cell carcinoma (52.9%). The temporal region was the most common site (41.2%) affected. Most of the defects were between 6.1 and 9.0 cm in diameter, followed by defects that were <3 cm in diameter. Neurosurgical assistance was required in 5 (29.4%) patients where the tumor had involved the skull bone. Tumor recurrence was noted in 3 (17.6%) patients within one year of follow-up. Conclusion: Scalp reconstruction after oncological resection presents a peculiar esthetic challenge due to the hair-bearing skin of the scalp and the need to maintain the hairline. The use of local flaps from the scalp remains the first and the best option. For very large scalp defects, free flap through microvascular surgery is the preferred option.

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The Role of Pedicled Latissimus Dorsi Flap in Scalp Defect Reconstruction Following Tumour Excision

Cited by 2 publications

References 9 publications

Pedicled Latissimus Dorsi Flap for Extensive Scalp Reconstruction in Acute Burns

Pedicled Latissimus Dorsi Flap for Extensive Scalp Reconstruction in Acute Burns

Scalp Reconstruction following Excision of Malignant Tumors in Southeastern Nigeria

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