Reconstructive limitations in severe scalp injuries.

Abstract

Although favored by an abundant regional blood supply, the healing of a large traumatic defect of the scalp on a spontaneous basis is frequently very slow and complicated, with an unstable scar a common sequel. Even when operative treatment is carefully planned and executed, functional and cosmetic results may be far from ideal. This is particularly true when the surgeon must deal with a large loss of hair-bearing tissue in combination with serious injuries to the adjacent face or cranium. An analysis of experiences in the management of a group of 7 youthful patients suffering severe injuries of the scalp serves to emphasize the practicality of certain procedures employed in their rehabilitation, as well as to demonstrate the limitations of others. The case reports illustrate indications for the use of free skin grafts, rotated scalp flaps, and tubed pedicle skin flaps in the repair of extensive head wounds; the usefulness