Scalp defects are commonly encountered in case of trauma or tumor excision.
DESCRIPTION OF THE PROCEDURES
Reconstruction depends on the areas involved in trauma or tumor. The reconstructive option with respect to size and depth of defect is:
Skin only
1. Bone not exposed 🡺 Skin grafting
2. Bone exposed🡺
I) Small to moderate size (roughly till 10x10cm wound)🡺 scalp rotational flap (rotation of hair bearing skin from normal area to the area of exposed bone)
II) Major wound 🡺 Such wounds might need microvascular reconstruction by bringing full thickness skin from forearm, thigh or back . This surgery may last for 6 to 8 hours as it requires anastomosis of blood vessels to keep that flap alive.
1. Bone involvement (scalp bone has outer and inner tables)
I) Involvement of outer table 🡺 does not need bone reconstruction
II) Involvement of both tables 🡺 will need reconstruction with prosthetic mesh / or artificial bone or outer table of bone from normal area of sclap to cover the defect.
EXPECTED COMPLICATIONS
Minor wound infections or partial skin necrosis
EXPECTED OUTCOME
Most of the times patient recovers smoothly
APPROXIMATE DURATION OF PROCEDURE
2 to 6 hours (depending on extent of involvement)
APPROXIMATE DURATION OF HOSPITAL STAY
2 to 5 days (may extend if procedure requires more than one sittings)
Chances of success 🡺 More than 95%
Long term effects
Hairless skin which may need hair transplant or any other secondary procedure.
SETUP REQUIRED FOR PROCEDURE
Inpatient stay

Written by : Dr. Safdar Ali
Copyrights: Pakistan association of Plastic Surgeons