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Scalp flaps

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https://www.readbyqxmd.com/read/28207463/implantation-of-thickened-artificial-bone-for-reduction-of-dead-space-and-prevention-of-infection-between-implant-and-dura-in-secondary-reconstruction-of-the-skull
#1
Mine Ozaki, Keigo Narita, Masakazu Kurita, Yuki Iwashina, Akihiko Takushima, Kiyonori Harii
For the treatment of skull defect compensation after neurosurgery, a customized artificial bone is often employed owing to its toughness and the relative ease of producing cosmetically good result. However, implants are vulnerable to infection and removal of implant is sometimes necessary. Several other treatment options such as autologous bone graft or free flap are likely to be considered for the secondary reconstruction to avoid reinfection; however, reimplantation of artificial bone is beneficial for the patients, being not concerned with donor site morbidity...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28194294/pedicle-temporalis-fascial-flap-with-axial-scalp-flap-obviates-need-of-free-flap-in-extensive-scalp-wound
#2
F W Nangole, S O Khainga
Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28191620/clinical-application-of-scalp-markers-and-three-dimensional-sliced-computer-tomography-reconstructions-of-the-skull-transverse-sigmoid-sinus-groove-in-the-retrosigmoid-approach
#3
Chao Wang, Han Guoqiang, Chao You, Chuangxi Liu
AIM: To explore the clinical value of bone flap creation and the sinus protection in the approach of retrosigmoid keyhole craniotomy with the guidance of three-dimensional (3D) sliced computer tomography (CT) reconstruction of the skull transverse sinus and sigmoid sinus groove. MATERIAL AND METHODS: The scalp tracings of the transverse sinus and sigmoid sinus groove of 108 posterior fossa lesion patients were delineated by gentian violet, which relies on the relationship between its 3D reconstruction location and scalp marker...
January 17, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28145935/the-rapid-development-of-squamous-cell-carcinoma-on-the-nasal-dorsum-of-a-patient-receiving-immunosuppressive-therapy
#4
Daiki Senda, Erika Ando, Doruk Orgun, Masatoshi Horiguchi, Atsushi Arakawa, Akiko Matsuda, Hiroshi Mizuno, Ayato Hayashi
The risk of cancer is significantly increased in patients undergoing renal transplant surgery than in the general population. In particular, skin cancer is the most commonly occurring cancer in these patients.A 34-year-old man underwent living renal transplantation for focal segmental glomerulosclerosis. After 18 months, he developed a lesion on the nasal dorsum, approximately 1 cm in size, and the lesion rapidly expanded to cover the entire dorsum.Owing to its rapid expansion, the lesion was suspected to be a malignant tumor and wide excision was planned...
January 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28143976/calvarial-metastasis-of-renal-cell-carcinoma
#5
Tabrez Suffee, Mohamed Derder, Julien Quilichini, Edouard Dezamis, Laurent Lantieri
The calvarium is an extremely unusual site of metastasis of renal cell carcinoma. We report a 62-year-old man who was enrolled for palliative medical management for an exophytic calvarial metastasis. His quality of life was greatly compromised with everyday local care and bandages due to recurrent events of infection and bleeding, limiting his social life. Surgical palliative surgery was carried out to improve the patient's quality of life. After tumour resection, the resultant defects of the calvarium and the scalp were covered by a muscular latissimus dorsi free flap and a fascia lata graft as dural substitute...
January 31, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28114212/the-anterolateral-thigh-flap-as-the-flap-of-choice-for-scalp-reconstruction
#6
Gregory A Lamaris, Rebecca Knackstedt, Rafael A Couto, Nasim Abedi, Paul Durand, Brian Gastman
INTRODUCTION: Large scalp soft tissue defects can present difficulties with reconstruction. The ideal flap for scalp reconstruction has yet to be described although the latissimus dorsi flap is frequently referred to as the first choice in this setting. PATIENTS AND METHODS: Following institutional review board approval, the authors reviewed their experience in scalp reconstruction for the past 4 years. Patient demographics, reconstruction indication, flap choice, complications, and outcomes were recorded...
January 20, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28060171/broader-practice-indications-for-mohs-surgical-defect-healing-by-secondary-intention-a-survey-study
#7
Chetan Vedvyas, Patricia L Cummings, Roy G Geronemus, Jeremy A Brauer
BACKGROUND: Recent reports have indicated secondary intention (SI) healing utilization for Mohs surgical defects beyond conventionally accepted indications. OBJECTIVE: To characterize potentially more expansive guidelines for when SI healing is indicated or appropriate in dermatologic surgery. METHODS: A survey study was e-mailed to the American College of Mohs Surgery in 2015. A group of 293 respondents addressed factors influencing decisions to heal surgical defects secondarily...
December 29, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28050439/rotation-flap-closure-of-moderate-size-scalp-defects-technique-and-outcome
#8
Philip Umman, Vinod G Pillai, Pradip M Abraham, Roshan G Varkey
Many patients present to general surgeons with scalp lesions which require wide local excision with margin, following which the defect is too large to be closed primarily. These lesions can be benign or malignant. Skin grafting of these defects gives poor cosmetic outcome. Knowledge of basic flaps will enable the general surgeon to close these defects to heal by primary intention. Also, the margin of excision will not be compromised because of anticipated difficulty in closing the wound. We present a series of three cases who underwent excision of scalp lesions resulting in moderate size scalp defects...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28045814/recalcitrant-invasive-skin-cancer-of-the-scalp-combined-extirpation-and-microsurgical-reconstruction-without-cranioplasty
#9
Gerald J Cho, Frederick Wang, Steven M Garcia, Jennifer Viner, William Y Hoffman, Michael W McDermott, Jason H Pomerantz
BACKGROUND: Recurrent invasive skin cancer of the scalp and calvarium is a difficult problem for which universally accepted treatment protocols have not been established. The authors present their 10-year experience with treatment of this specific subset of scalp reconstruction patients and present a successful treatment algorithm that is well suited to this patient population. METHODS: The authors retrospectively reviewed all patients of microsurgical scalp reconstruction performed from 2005 to 2015 that involved invasive cutaneous malignancies of the scalp and calvarium...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28043755/scalp-reconstruction-a-10-year-retrospective-study
#10
D Steiner, A Hubertus, A Arkudas, C D Taeger, I Ludolph, A M Boos, M Schmitz, R E Horch, J P Beier
Scalp reconstruction is a challenging task for the reconstructive surgeon. In consideration of the anatomical and cosmetic characteristics, the defect depth and size, an armamentarium of reconstructive procedures ranging from skin grafts over local flaps to free tissue transfer has been described. In this 10-year retrospective study, 85 operative procedures for scalp reconstruction were performed at our department. The underlying entity, defect size/depth, reconstructive procedure, complications, and mean hospital stay were analyzed...
December 7, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28027177/the-visor-flap-a-novel-design-for-scalp-wound-closure
#11
Lisa Hwang, Ni-Ka Ford, Jamie Spitz, Marco Ellis
Full-thickness scalp defects pose a reconstructive problem in the setting of infection, radiation, and underlying calvarial defects. Current options include dermal matrices, skin grafts, and local fasciocutaneous flaps. Free tissue transfer is frequently required when scalp-based flaps fail or the wound is significantly large or complex. The authors present 7 patients of complex scalp defect reconstruction using the novel visor flap. The visor flap is a bipedicled advancement flap with a triangular posterior extension...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005736/management-of-the-repeatedly-failed-cranioplasty-following-large-postdecompressive-craniectomy-establishing-the-efficacy-of-staged-free-latissimus-dorsi-transfer-tissue-expansion-custom-polyetheretherketone-implant-reconstruction
#12
Gerhard S Mundinger, Kerry Latham, Jeffery Friedrich, Otway Louie, Hakim Said, Craig Birgfeld, Richard Ellenbogen, Richard A Hopper
BACKGROUND: Postdecompressive craniotomy defect management following failed prior cranioplastyis challenging. The authors describe a staged technique utilizing free muscle transfer, tissue expansion, and custom polyetheretherketone (PEEK) implants for the management of previously failed cranioplasty sites in patients with complicating local factors. METHODS: Consecutive patients with previously failed cranioplasties following large decompressive craniectomies underwent reconstruction of skull and soft tissue defects with staged free latissimus muscle transfer, tissue expansion, and placement of custom computer-aided design and modeling PEEK implants with a 'temporalis-plus' modification to minimize temporal hollowing...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27998663/reconstruction-with-soft-tissue-free-flaps-for-large-defects-after-the-resection-of-giant-facial-neurofibroma
#13
L Hu, Y Xi, Y Wang, L Jiannan, J Han, Y Miao, S Gokavarapu, C Zhang, L Xu
Giant facial neurofibroma leads to disfigurement and functional and neurological deficits. Surgical resection is the mainstay of treatment and poses a great challenge to the surgeon with regard to the restoration of the defects arising from tumour resection. The cases of three male and three female patients diagnosed with giant facial neurofibroma, who underwent radical resection and reconstruction with soft tissue free flaps between 2008 and 2015, were analyzed retrospectively. Clinical data including patient sex, age, preoperative embolization of the nutrient artery, volume of blood loss, type and size of flaps used for reconstruction, and complications were recorded...
December 17, 2016: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27993740/a-technically-simple-and-safe-method-for-preparing-an-anterior-pericranial-flap-using-saline-injection-into-the-subgaleal-space-a-technical-note
#14
Jiwook Ryu, Sang Bong Chung, Seok Keun Choi, Sung Ho Lee, Yeongu Chung
INTRODUCTION: Cranial defects following anterior cranial base surgery have been frequently reconstructed using the pericranial flap. We present a simple technique for preparing the flap using injection of saline into the subgaleal space. SURGICAL TECHNIQUE: Ten minutes before skin incision, we inserted a 20-gauge needle perpendicular to 8-10 spots in the frontal area and injected 5-7 cc of saline at each spot. Distinctive swelling of the scalp was then observed...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27991695/application-of-extended-bi-pedicle-anterolateral-thigh-free-flaps-for-reconstruction-of-large-defects-a-case-series
#15
Michele Maruccia, Georgios Orfaniotis, Pedro Ciudad, Fabio Nicoli, Emanuele Cigna, Giuseppe Giudice, Kidakorn Kiranantawat, Diego Ribuffo, Hung-Chi Chen
BACKGROUND: The anterolateral thigh flap is a workforce flap in reconstructive surgery, however, variations in it is vascular anatomy are not uncommon. These variations may affect flap design and survival, especially when large flaps are required. In some anatomical variants the anterolateral thigh flap is supplied by two separate dominant pedicles, and in these cases a bi-pedicle modification may be necessary to ensure complete flap viability. The aim of this report is to evaluate the outcomes, and present our approach in using bi-pedicle anterolateral thigh flaps as a method to reduce the risk of partial flap necrosis when reconstructing sizeable soft tissue defects...
December 19, 2016: Microsurgery
https://www.readbyqxmd.com/read/27989981/heterotopic-intracranial-skin-presenting-as-chronic-draining-sinus-after-remote-craniotomy
#16
Husain Al-Qattan, Joanna E Gernsback, Ajani G Nugent, Kirill A Lyapichev, Ricardo J Komotar, Harvey Chim
BACKGROUND: Craniotomies for trauma are associated with a significant risk of wound complications. We report a case in which a chronic nonhealing draining sinus was caused by an ectopic epidermal lining deep to the craniotomy bone flap, adherent to the underlying dura. CASE DESCRIPTION: A 61-year-old man was examined for a 3-year-old, nonhealing scalp wound resulting after a traumatic brain injury. His initial surgery consisted of an intracranial hematoma evacuation through a temporoparietal craniotomy; this was complicated by wound dehiscence and a chronic sinus draining clear fluid that did not resolve with antimicrobial therapy...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27974011/use-of-anteromedial-thigh-perforator-flap-and-immunological-implications-of-gorlin-goltz-syndrome-a-case-study
#17
A Scalise, R Calamita, C Tartaglione, E Bolletta, G Di Benedetto, M Pierangeli
Gorlin-Goltz syndrome is mainly characterised by the development of numerous multicentric and relapsing cutaneous basal cell carcinomas (BCCs). A major problem for patients with Gorlin-Goltz syndrome is the large amount of BCCs that can invade the deep underlying structures, especially the face. Here, we describe the case of a 23-year-old male affected by Gorlin-Goltz syndrome. He had recurrent BCCs on a hairless scalp and dorsum since he was 17 years old and underwent four surgical procedures to excise BCCs, including a reconstruction with anteromedial thigh perforator flap...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27922966/local-coverage-for-acute-severely-herniated-brain-using-scalp-and-forehead-flaps-in-a-pediatric-patient-with-head-trauma
#18
Matthew Brown, Navid Pourtaheri, Kristopher Katira, Sunil Manjila, Ali S Totonchi
A 4-year-old-boy required emergent craniectomy and drainage of a large right-sided acute subdural hematoma after head trauma, during which massive sinus hemorrhage with brain swelling occurred. Acute intraoperative management entailed dural cover using synthetic dural membrane substitute and scalp coverage over the herniated brain using acellular dermal matrix. After intensive monitoring and control of raised intracranial pressure over the next few days, the exposed brain was then covered by scalp and forehead flaps with cadaveric skin grafting to the donor site...
January 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27909467/invasive-squamous-cell-carcinoma-of-the-scalp-and-calvarium-a-multidisciplinary-approach
#19
Jennifer Stark, Silvio Podda, Karen Szymanski
Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage...
2016: Eplasty
https://www.readbyqxmd.com/read/27900320/the-golden-spiral-flap-a-new-flap-design-that-allows-for-closure-of-larger-wounds-under-reduced-tension-how-studying-nature-s-own-design-led-to-the-development-of-a-new-surgical-technique
#20
Sharad P Paul
This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is nature's own pattern for rapid expansion. Given the relationship between tissue expansion and stretch has been shown to cause deformation gradients that have both elastic and growth factors, the author set out to test the hypothesis that a golden spiral pattern therefore would be more efficient at closing wounds under less tension when compared with standard semicircular rotational flap patterns...
2016: Frontiers in Surgery
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