Aplasia Cutis Congenita – Plastic Reconstruction of three Scalp and Skull Defects with two Opposed Scalp Rotation Flaps and Split Thickness Skin Grafting

Abstract

Aplasia cutis congenita (ACC) is a rare congenital defect of skin and subcutaneous tissue, more rarely of periosteum, skull and dura. The lesions can involve any location, but most common are scalp defects. We report on the successful treatment of three large defects of the scalp with skull involvement in a newborn girl by early debridement and defect closure with two opposed scalp rotation flaps and an occipital split-thickness skin graft.

Key words

aplasia cutis congenita (ACC) - congenital skull defects - scalp rotation flap

References

• 1 Arkudas A, Tjiawi J, Saumweber A. et al . Evaluation of blood vessel ingrowth in fibrin gel subject to type and concentration of growth factors.  J Cell Mol Med. 2008; Jun;  28 [Epub ahead of print] 
• 2 Azad S, Falder S, Harrison J. et al . An adherent dressing for aplasia cutis congenita.  Br J Plast Surg. 2005;  58 1159-1161
• 3 Bajpai M, Pal K. Aplasia cutis cerebri with partial acrania − total reconstruction in a severe case and review of the literature.  J Pediatr Surg. 2003;  38 e4
• 4 Bilginer B, Onal MB, Bahadir S. et al . Aplasia cutis congenita of the scalp, skull and dura associated with Adams-Oliver syndrome.  Turk Neurosurg. 2008;  18 191-193
• 5 Frieden IJ. Aplasia cutis congenita: A clinical review and proposal for classification.  J Am Acad Dermatol. 1986;  14 646-660
• 6 Koshy CE, Waterhouse N, Peterson D. Large scalp and skull defects in aplasia cutis congenita.  Br J Plast Surg. 2001;  54 276-277
• 7 Krathen MS, Rosenbach M, Yan AC. et al . Focal preauricular dermal dysplasia: Report of two cases and a review of literature.  Pediatr Dermatol. 2008;  25 344-348
• 8 Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: An algorithmic approach.  Plast Reconstr Surg. 2005;  116 54e-72e
• 9 Ploplys EA, Muzaffar AR, Gruss JS. et al . Early composite cranioplasty in infants with severe aplasia cutis congenita: A report of two cases.  Cleft Palate Craniofac J. 2005;  42 442-447
• 10 Ribuffo D, Costantini M, Gullo P. et al . Aplasia cutis congenita of the scalp, the skull, and the dura.  Scand J Plast Reconstr Surg Hand Surg. 2003;  37 176-180
• 11 Theile RJ, Lanigan MW, McDermant GR. Reconstruction of aplasia cutis congenita of the scalp by split rib cranioplasty and a free latissimus dorsi muscle flap in a nine month old infant.  Br J Plast Surg. 1995;  48 507-510
• 12 Verhelle NA, Heymans O, Deleuze JP. et al . Abdominal aplasia cutis congenita: Case report and review of the literature.  J Pediatr Surg. 2004;  39 237-239
• 13 Wexler A, Harris M, Lesavoy M. Conservative treatment of cutis aplasia.  Plast Reconstr Surg. 1980;  86 1066-1071
• 14 Yang JY, Yang WG. Large scalp and skull defect in aplasia cutis congenita.  Br J Plast Surg. 2000;  53 619-622

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