Tissue expansion in operated cases of transposition flap of scalp for correction of donor site alopecia and patient’s satisfaction
DOI:
https://doi.org/10.18203/2349-2902.isj20182747Keywords:
Level of evidence, Level IV, Therapeutic studyAbstract
Background: Scalp defects managed by local transposition flaps with donor site alopecia are aesthetically not acceptable to patients. Scalp expansion with tissue expanders is needed for proper correction of this deformity.
Methods: Authors retrospectively reviewed all cases of post traumatic and post burn scalp defects that were managed initially by local transposition flap and later by scalp expansion by tissue expanders at our institute over a period of 5 years and conducted an outcome survey. Authors’ institutional protocol in such patients and results of the review are presented.
Results: Twenty-eight patients were included in the study. Eight patients had post traumatic and 20 cases had post electric burn scalp defect. The mean age of patients was 28.92±8.26 years. Thirty-eight tissue expanders of various sizes (200-600 ml) were used in 28 patients. The mean follow-up time was 9.07±1.92 months. Major complication rate in present study was 2.63%. Results of outcome survey revealed more than 90% patients were satisfied after third surgery.
Conclusions: Scalp transposition flap donor site alopecia can be easily corrected by tissue expansion. The complications are not severe and can be managed easily. It should be offered to all such types of patients, as it leads to proper social rehabilitation and satisfaction among these groups of patients.
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References
Strayer LM. Augustin Belloste and the Treatment for Avulsion of the Scalp: The Odd History of an Operation in Head Surgery. N Eng J Med. 1939;220(22):901-5.
Netolitzky J. On the case of skin transplantation. Vienna Med Weekday. 1871;21:820-2.
Robinson EF. Total avulsion of the scalp. Surg Gynecol Obstet. 1908;7:663.
Marcks KM, Trevaskis AE, Nauss TJ. Scalp defects and their repair. Plastic Reconstruct Surg. 1951;7(3):237-43.
Gaisford JC, Hanna DC, Susen AF. Major resection of scalp and skull for cancer with immediate complete reconstruction-fourteen cases. Plastic Reconstruct Surg. 1958;21(5):335-44.
Coleman Jr CC. Scalp flap reconstruction in head and neck cancer patients. Plastic Reconstruct Surg. 1959;24(1):45-52.
Orticochea M. Four flap scalp reconstruction technique. Br J Plastic Surg. 1967;20:159-71.
Orticochea M. New three-flap scalp reconstruction technique. Br J Plastic Surg. 1971;24:184-8.
Neumann CG. The expansion of an area of skin by progressive distention of a subcutaneous balloon: Use of the method for securing skin for subtotal reconstruction of the ear. Plastic Reconstruct Surg. 1957;19(2):124-30.
Radovan C. Tissue expansion in soft-tissue reconstruction. Plastic Reconstruct Surg. 1984;74(4):482-92.
Azzolini A, Riberti C, Cavalca D. Skin expansion in head and neck reconstructive surgery. Plastic Reconstruct Surg. 1992;90(5):799-807.
1Guzel MZ, Aydin Y, Yucel A, Hariri S, Altintas M. Aesthetic results of treatment of large alopecia with total scalp expansion. Aesthetic Plastic Surg. 2000;24(2):130-6.
Manders EK, Graham WP, Schenden MJ, Davis TS. Skin expansion to eliminate large scalp defects. Ann Plastic Surg. 1984;12(4):305-12.
Bauer B. Tissue expansion.In: Beasley RW, Aston S, Bartlatt S, Gurtner G, Spear S. Grabb and Smith`s plastic surgery. 6th edition. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins; 2007.
Gürlek A, Alaybeyoğlu N, Demir CY, Aydoğan H, Bilen BT, Æztürk A. Aesthetic reconstruction of large scalp defects by sequential tissue expansion without interval. Aesthetic Plastic Surg. 2004;28(4):245-50.