Protocols and complications in the reconstruction of major scalp defects

Introduction: This study aimed to analyze the protocols and complications in four unusual cases of large and complex scalp defects, in which conventional, non-microsurgical flaps were used. Methods: This was a critical and retrospective analysis of four cases. Three immunosuppressed pati...

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Main Authors: Julio Wilson Fernandes, Kátia Sheylla Malta Purim, Michael Hikaru Mikami
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2020-03-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/2709/en_v35n1a22.pdf
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author Julio Wilson Fernandes
Kátia Sheylla Malta Purim
Michael Hikaru Mikami
author_facet Julio Wilson Fernandes
Kátia Sheylla Malta Purim
Michael Hikaru Mikami
author_sort Julio Wilson Fernandes
collection DOAJ
description Introduction: This study aimed to analyze the protocols and complications in four unusual cases of large and complex scalp defects, in which conventional, non-microsurgical flaps were used. Methods: This was a critical and retrospective analysis of four cases. Three immunosuppressed patients had squamous cell carcinomas (SCC) (one underwent liver transplant, one underwent renal transplant, and one had rheumatoid arthritis). The other patient had sequelae of head trauma and multiple neurosurgeries using self-polymerizing acrylic, followed by osteomyelitis and fistula. Results: The cases of large carcinoma were reconstructed with rotation large scalp flaps. Two of them had epidermolysis/necrosis in a small distal portion of the flaps, which were treated, with excellent aesthetic results. The case of sequelae of trauma was reconstructed with expanded advancement scalp flap over cranioplasty using ribs. Despite the extrusion of one osteosynthesis, the patient healed without recurrence of the fistula, with na excellent aesthetic result. Conclusion: The analysis of these complex and unusual cases indicates that temporal pedicles are preferred in the planning of flaps for the conventional reconstruction of large scalp defects. The treatment employed for the possible epidermolyses and distal necroses in these flaps led to satisfying aesthetic and functional results.
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spelling doaj-art-8bc1e71ea092409f9680c8ef7e30e31a2025-08-20T02:52:35ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352020-03-01350113313710.5935/2177-1235.2020RBCP0022Protocols and complications in the reconstruction of major scalp defectsJulio Wilson Fernandes0Kátia Sheylla Malta Purim1Michael Hikaru Mikami2Universidade Positivo, Curitiba, PR, BrazilUniversidade Positivo, Curitiba, PR, BrazilFaculdade Evangélica Mackenzie do Paraná, Curitiba, PR, BrazilIntroduction: This study aimed to analyze the protocols and complications in four unusual cases of large and complex scalp defects, in which conventional, non-microsurgical flaps were used. Methods: This was a critical and retrospective analysis of four cases. Three immunosuppressed patients had squamous cell carcinomas (SCC) (one underwent liver transplant, one underwent renal transplant, and one had rheumatoid arthritis). The other patient had sequelae of head trauma and multiple neurosurgeries using self-polymerizing acrylic, followed by osteomyelitis and fistula. Results: The cases of large carcinoma were reconstructed with rotation large scalp flaps. Two of them had epidermolysis/necrosis in a small distal portion of the flaps, which were treated, with excellent aesthetic results. The case of sequelae of trauma was reconstructed with expanded advancement scalp flap over cranioplasty using ribs. Despite the extrusion of one osteosynthesis, the patient healed without recurrence of the fistula, with na excellent aesthetic result. Conclusion: The analysis of these complex and unusual cases indicates that temporal pedicles are preferred in the planning of flaps for the conventional reconstruction of large scalp defects. The treatment employed for the possible epidermolyses and distal necroses in these flaps led to satisfying aesthetic and functional results.http://www.rbcp.org.br/export-pdf/2709/en_v35n1a22.pdfscalpreconstructive surgical procedureshead and neck neoplasmspenetrating head traumaorgan transplantation
spellingShingle Julio Wilson Fernandes
Kátia Sheylla Malta Purim
Michael Hikaru Mikami
Protocols and complications in the reconstruction of major scalp defects
Revista Brasileira de Cirurgia Plástica
scalp
reconstructive surgical procedures
head and neck neoplasms
penetrating head trauma
organ transplantation
title Protocols and complications in the reconstruction of major scalp defects
title_full Protocols and complications in the reconstruction of major scalp defects
title_fullStr Protocols and complications in the reconstruction of major scalp defects
title_full_unstemmed Protocols and complications in the reconstruction of major scalp defects
title_short Protocols and complications in the reconstruction of major scalp defects
title_sort protocols and complications in the reconstruction of major scalp defects
topic scalp
reconstructive surgical procedures
head and neck neoplasms
penetrating head trauma
organ transplantation
url http://www.rbcp.org.br/export-pdf/2709/en_v35n1a22.pdf
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AT katiasheyllamaltapurim protocolsandcomplicationsinthereconstructionofmajorscalpdefects
AT michaelhikarumikami protocolsandcomplicationsinthereconstructionofmajorscalpdefects