Superficial Temporal Artery Based Pedicled Flap for the Reconstruction of Traumatic Complicated Scalp Defects

Abstract

Reconstruction of traumatic defects on the scalp can be challenging. In cases of skull trauma, direct incisions close to bony defects can lead to skin and soft tissue necrosis. To minimize hair damage after surgery and to achieve both reconstructive and cosmetic effects, we propose a superficial temporal artery based pedicled flap for complicated traumatic cranial defects and lacerations. In the present case, a 21-year-old woman suffered intracranial hemorrhage with multiple skin and soft tissue injuries on her scalp after a violent attack. Neurosurgeons made a bicoronal incision for intracranial surgery and cranioplasty with a meshed plate, however 3×2.5 cm skin and soft tissue necrosis occurred on the mid-scalp near the vertex with plate exposure. We therefore elevated a 15×8 cm-sized pedicled flap based on a unilateral superficial temporal artery and transferred it to the defect without tension. The donor site was closed in a V-Y advancement pattern. Healing was uneventful, with good hairline and hair growth patterns observed. From our experience, we suggest a superficial temporal artery pedicled flap for complicated traumatic scalp defects.