Abstract
Composite scalp and cranium defects, which require microsurgical reconstruction, result from tumor resection, radiation, trauma, severe burn injuries, and rarely vasculitic disorders. In the current study, the authors aim to compare the outcomes of the fasciocutaneous flaps and musculocutaneous free flaps used for the reconstruction of extensive composite scalp and cranium defects. From 2010 to 2017, 21 patients who underwent composite scalp and cranium defect reconstruction with a free flap were retrospectively identified. Eighteen patients had squamous cell carcinoma, 2 patients had meningioma, and 1 patient had Ewing sarcoma. Thirteen musculocutaneous free flaps including latissimus dorsi and vertical rectus abdominis flaps and 9 free fasciocutaneous flaps including radial forearm and anterolateral thigh flaps were used. Only 1 flap loss was encountered. No neurologic impairment in postoperative period was reported. The mean length of stay in the hospital, the duration of surgery, and total volume of blood transfusion for the fasciocutaneous flap group were significantly shorter than those for musculocutaneous flap group. No flap atrophy was reported in fasciocutaneous flap group. Reconstruction of the composite scalp and cranium defects with fasciocutaneous free flaps allows shorter hospitalization, less blood transfusion and less flap atrophy than those of musculocutaneous flaps. To this respect, their usage should be prioritized in such challenging patients.
Highlights
From the ÃDepartment of Plastic, Reconstructive and Aesthetic Surgery, Composite scalp and cranium defects, which require microsurgical reconstruction, result from tumor resection, radiation, trauma, severe burn injuries, and rarely vasculitic disorders.[1,2,3] These soft tissue and bone defects are distinct with regard to anatomy, complication rates, and reconstructive options
When compared to each other, radial forearm flap (RFF) and anterolateral thigh (ALT) flap showed no significant difference in terms of duration of hospitalization
Sweeny et al[9] showed that radial forearm free flap was associated with few complications and shorter duration of hospitalization when compared to latissimus dorsi musculocutaneous (LD) and VRAM flaps
Summary
The current study was conducted according to the Declaration of Helsinki. Informed consent was obtained from each patient. From 2010 to 2017, 21 patients who underwent composite scalp and cranium defect reconstruction with a free flap were retrospectively identified. Patients were excluded from the study if they had a reconstruction other than a free flap, if they had only scalp defect reconstructed with a free flap, if they had only split thickness cranium defect or if they had combined defects of the periorbita and/or midface regions. The patients meeting these criteria were grouped into 2 categories according to the composition of the flap: fasciocutaneous or musculocutaneous
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
