Use of scalp flaps as a salvage procedure in reconstruction of the large defects of head and neck region

Abstract

Large defects of the scalp, head and neck region are often encountered by plastic surgeons. The repair of such defects is dependent upon their location, size and depth. This study describes the use of large scalp flaps as a salvage procedure in the reconstruction of large scalp, head and neck region defects in elderly patients with poor general condition or advanced malignancy. The presented study includes 22 patients operated between 2007 and 2011 for the reconstruction of large defects of the hair-bearing skin and head/neck region with large scalp flaps. A defect exceeding 25 cm² area was classified as "large" as defined in the previous studies. The patients' medical records were analyzed. Scalp flaps provided a satisfactory and durable reconstruction in the late follow-up term. All flaps were completely survived except in one case in which a partial necrosis in the distal margin occurred. Major complications were recorded in 4.5% of patients while minor complications were recorded in 13.5% of them. In conclusion, large scalp flaps should be considered as a salvage procedure for reconstruction of large scalp, head and neck defects especially for palliative situations in elderly patients with significant comorbidities and advanced malignancies.