The use of galeotomies to aid the closure of surgical defects on the forehead and scalp

The contralateral subgaleal sliding flap for the single-stage reconstruction of large defects of the temple and lateral forehead

“…While this approach may suffice for small‐to‐medium sized defects, for larger and more medially based defects of the lateral forehead this reservoir is not readily accessible. Various techniques have thus been advocated to increase tissue movement in this facial region including the use of galeotomies and imbrication sutures …”

Early Surgical Excision of Giant Congenital Hemangiomas of the Scalp in Newborns: Clinical Indications and Reconstructive Aspects

“…46 On the other hand, inappropriately performed galeotomies can lead to potential flap necrosis, too much bleeding or postoperative blood loss, and probably flap failure. 48 However, skin expansion remains a viable solution for children older than 3 years or in cases of huge lesions in which flap reconstruction is less appropriate and not advisable. 49 Purse-string closure is another option for treating excisional defects.…”

Galeal/periosteal flaps for the reconstruction of large scalp defects with exposed outer table

“…Generally, local flaps have to be designed much larger on the scalp due to the inelasticity of the galea, and may be associated with significant intraoperative or postoperative bleeding, necrosis and infection. Alternative techniques include the use of galeotomies 4 (usually multiple to facilitate primary closure), granulation tissue flaps, 5 delayed full‐thickness skin graft repair (which after a period of secondary intention healing results in a vascularized wound bed upon which to place such a graft) and the potential use of collagen matrix materials 6 …”