J Neurol Surg B Skull Base 2016; 77(01): 032-037
DOI: 10.1055/s-0035-1556874
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Scalp Rotation Flap for Reconstruction of Complex Soft Tissue Defects

Dary J. Costa
1   Department of Otolaryngology, Saint Louis University School of Medicine, St. Louis, Missouri, United States
2   Department of Otolaryngology, Cardinal Glennon Children's Medical Center, St. Louis, Missouri, United States
,
Scott Walen
1   Department of Otolaryngology, Saint Louis University School of Medicine, St. Louis, Missouri, United States
,
Mark Varvares
1   Department of Otolaryngology, Saint Louis University School of Medicine, St. Louis, Missouri, United States
,
Ronald Walker
1   Department of Otolaryngology, Saint Louis University School of Medicine, St. Louis, Missouri, United States
› Author Affiliations
Further Information

Publication History

22 July 2014

14 May 2015

Publication Date:
03 August 2015 (online)

Abstract

Importance Scalp reconstructions may be required after tumor resection or trauma. The inherent anatomy of the scalp presents challenges and may limit reconstructive options.

Objective To describe and investigate the scalp rotation flap as a reconstructive technique for complex soft tissue defects.

Design Retrospective case series with a mean follow-up of 13 months.

Setting Tertiary academic center.

Participants A total of 22 patients with large scalp soft tissue defects undergoing scalp rotation flap reconstruction.

Interventions The flap is designed adjacent to the defect and elevated in the subgaleal plane. The flap is rotated into the defect, and a split-thickness skin graft is placed over the donor site periosteum.

Main Outcomes and Measure Data points collected included defect size, operative time, hospital stay, and patient satisfaction with cosmetic outcome.

Results Mean patient age was 71 years. Mean American Society of Anesthesiologist classification was 2.8. Mean defect size was 41 cm2 (range: 7.8–120 cm2), and 19 of 22 defects resulted from a neoplasm resection. Mean operative time was 181 minutes, and mean hospital stay was 2.4 days. There were no intraoperative complications. Three patients with previous radiation therapy had distal flap necrosis. Twenty-one patients (95%) reported an acceptable cosmetic result.

Conclusions and Relevance The scalp rotation flap is an efficient and reliable option for reconstructing complex soft tissue defects. This can be particularly important in patients with significant medical comorbidities who cannot tolerate a lengthy operative procedure.

Note

The principal investigator (D.C.) had access to all of the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis.