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Case Reports
. 2023 Jun;24(3):129-132.
doi: 10.7181/acfs.2023.00129. Epub 2023 Jun 20.

Reconstruction of a temporal scalp defect without ipsilateral donor vessel possibilities using a local transposition flap and a latissimus dorsi free flap anastomosed to the contralateral side: a case report

Jung Kwon An  1 , Seong Oh Park  1 , Lan Sook Chang  1 , Youn Hwan Kim  1 , Kyunghyun Min  1
Affiliations
Case Reports

Reconstruction of a temporal scalp defect without ipsilateral donor vessel possibilities using a local transposition flap and a latissimus dorsi free flap anastomosed to the contralateral side: a case report

Jung Kwon An et al. Arch Craniofac Surg. 2023 Jun.

Abstract

Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.

Keywords: Case reports; Free tissue flaps; Latissimus dorsi; Reconstructive surgical procedures; Scalp.

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Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
A 42-year-old woman with a right temporal region scalp defect. (A) An 18×6 cm defect is observed in the right temporal area 31 days after decompressive craniectomy. (B) Computed tomography shows total occlusion of the right external carotid artery (red arrow).
Fig. 2.
Fig. 2.
Perioperative photographs. (A) The transposition flap donor site shows a visible scar of the hemicoronal incision (red arrow). (B) An additional sagittal, linear incision is made on the scalp 12 cm away from the left superficial temporal artery for flap elevation, considering the maximal length of the latissimus dorsi free flap pedicle. The flap is transposed to the temporal area to cover the original defect, resulting in a new 18×7 cm sized defect in the fronto-parietal area. (C) The new defect is covered with a latissimus dorsi free flap using the left superficial temporal vessels as the recipient.
Fig. 3.
Fig. 3.
Postoperative photographs. (A) In order to prevent compression of the pedicle, a 12×3 cm split-thickness skin graft from the left flank is placed over the pedicle (red arrow). (B) The donor site is closed primarily.
Fig. 4.
Fig. 4.
Photograph 44 days after surgery. Both the transposition flap and the latissimus dorsi free flap remained stable after the reconstruction procedure.
See this image and copyright information in PMC

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References

    1. Na Y, Shin D, Choi H, Kim J, Lee M. Scalp reconstruction using the reverse temporalis muscle flap: a case report. Arch Craniofac Surg. 2022;23:134–8. - PMC - PubMed
    1. Innocenti A, Menichini G, Innocenti M. Six-years experience in major scalp defect reconstruction with free flap: analysis of the results. Acta Biomed. 2022;92:e2021301. - PMC - PubMed
    1. Lutz BS, Wei FC, Chen HC, Lin CH, Wei CY. Reconstruction of scalp defects with free flaps in 30 cases. Br J Plast Surg. 1998;51:186–90. - PubMed
    1. Moon SJ, Jeon HB, Kim EH, Lew DH, Kim YO, Hong JW. Staged reconstruction of a chronically infected large skull defect using free tissue transfer and a patient-specific polyetheretherketone implant. Arch Craniofac Surg. 2020;21:309–14. - PMC - PubMed
    1. Jang HU, Choi YW. Scalp reconstruction: a 10-year experience. Arch Craniofac Surg. 2020;21:237–43. - PMC - PubMed

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