Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 22;8(4):e2741.
doi: 10.1097/GOX.0000000000002741. eCollection 2020 Apr.

Crane Principle Revisited

Affiliations

Crane Principle Revisited

Hamed M Kadry et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Scalp and forehead defects represent one of the most complex defects for reconstruction. The nature of these sites being hair bearing, together with the complicated nature of the injuries, for example, electrical burns and motor vehicle accidents, and of course the aesthetic concern being in the face, all add to the complexity of reconstruction.

Methods: This is a case series representing the experience of the authors in using the "crane principle" in the reconstruction of various defects in the forehead and the scalp presented to emergency department, Cairo University Hospital, for the period between January 2018 and January 2019.

Results: Twenty patients, 15 men and 5 women, presented with various soft tissue defects of the forehead and the scalp. The injuries of eighteen patients were due to motor vehicle accidents, and 2 patients had postelectrical burns. Age range was from 20 to 65 years, with a mean follow-up of 8 months. The number of total complications was 5. Three patients had wound dehiscence, and 2 patients had ulceration in the grafts placed at the flap donor site.

Conclusion: Crane principle represents an adequate reconstruction tool for forehead and scalp defects especially when the access to free flap and more complex reconstruction techniques is not available.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Various forehead and scalp defects following motor vehicle accidents (A, B) and electrical burn (C).
Fig 2.
Fig 2.
During the second stage of reconstruction, the flap was elevated from the site of injury, and the graft was recycled from the flap’s donor site to be placed at the original site of injury.
Fig. 3.
Fig. 3.
Female patient following motor vehicle accident (A). Debridement and a rotational flap done with split thickness of the donor site using the crane principle. The rotational flap is returned to its original site with grafting of the forehead (B). Defect size 11 × 10 cm.
Fig. 4.
Fig. 4.
Female patient following motor vehicle accident (A, B). Debridement and a rotational flap done with split thickness of the donor site using the crane principle (B). Notice the ulceration in the donor site. The rotational flap is returned to its original site with grafting of the temple region (C). Triangular defect measuring 11 × 10 × 4 cm.

References

    1. Skoog T. The surgical treatment of burns. Acta Chir Scand. 1963;305(Suppl):37. - PubMed
    1. Millard DR. The crane principle for transport of subcutaneous tissue. Plast Reconstr Surg. 1969;43:451–462. - PubMed
    1. Pribaz JJ, Maitz PK, Fine NA. Flap prefabrication using the “vascular crane” principle: an experimental study and clinical application. Br J Plast Surg. 1994;47:250–256. - PubMed
    1. Edgerton MT, Snyder GB. Combined intracranial-extracranial approach and use of the two stage split flap technic for reconstruction with craniofacial malignancies. Am J Surg. 1965;110:595–602. - PubMed
    1. Crokett DJ. The Millard ‘Crane flap’ for acute hand injuries. Plast Reconstr Surg. 1970;2:156–159. - PubMed