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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Thieme Revinter Publicações Ltda.
2020-03-01
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| 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. |
| format | Article |
| id | doaj-art-8bc1e71ea092409f9680c8ef7e30e31a |
| institution | DOAJ |
| issn | 1983-5175 2177-1235 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Cirurgia Plástica |
| 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 |
| work_keys_str_mv | AT juliowilsonfernandes protocolsandcomplicationsinthereconstructionofmajorscalpdefects AT katiasheyllamaltapurim protocolsandcomplicationsinthereconstructionofmajorscalpdefects AT michaelhikarumikami protocolsandcomplicationsinthereconstructionofmajorscalpdefects |