A simple modification in snail rotation flap used for scalp reconstruction

Abstract

The scalp is different, unlike any other site in the head and neck, it has the thickest skin in the human body and covers bone that protects the intracranial structures. Due to the special nature of scalp tissue, the reconstruction of defects is a challenging task. Many techniques have been used in scalp reconstruction from a simple approximation of the two edges of the scalp lesion, rotation flaps with their techniques as triple rotation, double-opposing rotation, pinwheel flaps up to utilization of regional flaps and tissue expanders. This study aims to introduce a small alteration in both the design and closure technique of the snail rotation flap used in scalp reconstruction to allow less rotation and easier approximation of the flap. This modified flap was used to manage seven cases three females and four males with scalp defects presented to the Oral and Maxillofacial Surgery Department, College of Oral and Dental Surgery, Misr University for Science and Technology and Dermatology, Venereology, and Andrology unit in the Memorial Souad Kafafi University Hospital, Misr University for Science and Technology. Results: Healing was optimum for all the patients except for one case who showed minimum dehiscence, hair shaft orientation was not markedly affected. Conclusions: closure of scalp defects is a challenge to surgeons due to the nature of the scalp and its surrounding tissues. This simple modification can help in scalp reconstruction with minimum tension and accepted healing.