Bipedicled Scalp Flap for Coverage of a Frontal Loss of Substance: About One Case

Abstract

Introduction: Scalp defects are frequent in the daily practice of plastic surgeons. Their etiologies are multiple; they can be of tumoral origin, infectious, secondary to a burn, post-traumatic… The great vascular richness of the scalp explains the possibility of using local flaps. Clinical Case: This is an 80-year-old patient with ATCD: arterial hypertension under treatment. The onset of symptoms dates back 10 years when the patient was operated on by neurosurgeons for a frontal meningioma for which she underwent excision + cranioplasty. The patient presented after 10 years for cranioplasty rejection with signs of local infection. The decision to remove the prosthetic material and cover the loss of substance was taken. After removal of the cranioplasty material by the team of neurosurgeons, we decided to perform a bi-pedicled scalp flap vascularized by the occipital pedicle and the posterior auricular pedicle, the donor area was grafted. The postoperative course was unremarkable. The result was considered good without complications. Conclusion: The anatomical particularities of the scalp explain all the originality of the reconstructions of this region. In our patient, the advantage of using the bipediculated flap is its extreme reliability, especially when the cranial vault has to be sacrificed.