Reconstruction of Large Acquired Scalp Defects: Ten-Year Experience.

Abstract

The method of choice for reconstruction of large acquired scalp defects depends on numerous factors. The aim of our study was to analyze reconstructions of large acquired scalp defects performed on 135 patients in the period of 10 years. We have monitored the factors with an impact on the reconstruction method, complications, and the achieved results. Skin grafts, local, regional and free flaps, have been applied for reconstruction of defects. The depth, size, defect localization, condition of surrounding tissue, co-morbidities and causes of occurrence of defect have an impact on the method of choice for defect reconstruction. Acquired scalp defects are the most frequent in the older population and, in most cases, occur upon the surgical removal of malignant tumors. Local fasciocutaneous flaps are the method of choice for small and acquired scalp defects of medium size while free flaps are the best solution for reconstruction of the large full-thickness scalp defects. Frequency of severe complications is significantly higher in the patients who undergo craniotomy, or those with liquorrhea.