Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping

Introduction: Scalping is characterized by trauma in the scalp region, which can be classified as partial or total. Scalping trauma is extremely mutilating and stigmatizing, especially when exposing the bone without periosteum, leading to chronic osteomyelitis and external table erosion. When there...

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Main Authors: Daniel Nowicki Kaam, André Coelho Nepomuceno, Gabriel Diniz Nishimura, Fernando Giovanetti Morano, Juliano Pereira, Juliana Gulelmo Staut, Jose Carlos Marques de Faria, Rodrigo Pinto Gimenez
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2021-09-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/2995/en_v36n3a19.pdf
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author Daniel Nowicki Kaam
André Coelho Nepomuceno
Gabriel Diniz Nishimura
Fernando Giovanetti Morano
Juliano Pereira
Juliana Gulelmo Staut
Jose Carlos Marques de Faria
Rodrigo Pinto Gimenez
author_facet Daniel Nowicki Kaam
André Coelho Nepomuceno
Gabriel Diniz Nishimura
Fernando Giovanetti Morano
Juliano Pereira
Juliana Gulelmo Staut
Jose Carlos Marques de Faria
Rodrigo Pinto Gimenez
author_sort Daniel Nowicki Kaam
collection DOAJ
description Introduction: Scalping is characterized by trauma in the scalp region, which can be classified as partial or total. Scalping trauma is extremely mutilating and stigmatizing, especially when exposing the bone without periosteum, leading to chronic osteomyelitis and external table erosion. When there are extensive scalp lesions above 200cm2, and with periosteum, the lesion is required a large amount of tissue with microsurgical flap, which is not available in all centers. This work aims to report a case of a 69-year-old female patient who suffered trauma due to total avulsion of a big scalp of 550cm2 with exposure of a skull cap without periosteum and total unviability of the scalp after a dog bite. Due to the total unviability of the avulsed scalp, we opted to transplant a large dorsal muscle free flap with microvascular anastomosis of the thoracodorsal pedicle with the superficial temporal vessels. The flap evolved with good perfusion, and partial grafting was performed in the bloody area. Methods: Retrospective analysis of the medical records of the patient in question. This paper follows the Declaration of Helsinki's standards and the approval of the Ethics and Research Committee. Conclusion: The free flap of the large dorsal muscle proved effective in this case of reconstruction of the scalp's extensive lesion (550cm2) with partial periosteum lesion due to scalping. The flap recovered the shape of the skull and the protective function of the skull cap.
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publishDate 2021-09-01
publisher Thieme Revinter Publicações Ltda.
record_format Article
series Revista Brasileira de Cirurgia Plástica
spelling doaj-art-acaa7f13b26245918aa91f930f00e3ac2025-08-20T03:57:08ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352021-09-01360325335710.5935/2177-1235.2021RBCP0025Scalp reconstruction with large dorsal muscle-free flap after dog bite scalpingDaniel Nowicki Kaam0André Coelho Nepomuceno1Gabriel Diniz Nishimura2Fernando Giovanetti Morano3Juliano Pereira4Juliana Gulelmo Staut5Jose Carlos Marques de Faria6Rodrigo Pinto Gimenez7Plastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilPlastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilPontifical Catholic University of Campinas, Campinas, SP, BrazilPlastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilPlastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilPlastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilPontifical Catholic University of Campinas, Campinas, SP, BrazilPlastic Surgery Service Prof. Dr. Ricardo Baroudi, Plastic Surgery, Campinas, SP, BrazilIntroduction: Scalping is characterized by trauma in the scalp region, which can be classified as partial or total. Scalping trauma is extremely mutilating and stigmatizing, especially when exposing the bone without periosteum, leading to chronic osteomyelitis and external table erosion. When there are extensive scalp lesions above 200cm2, and with periosteum, the lesion is required a large amount of tissue with microsurgical flap, which is not available in all centers. This work aims to report a case of a 69-year-old female patient who suffered trauma due to total avulsion of a big scalp of 550cm2 with exposure of a skull cap without periosteum and total unviability of the scalp after a dog bite. Due to the total unviability of the avulsed scalp, we opted to transplant a large dorsal muscle free flap with microvascular anastomosis of the thoracodorsal pedicle with the superficial temporal vessels. The flap evolved with good perfusion, and partial grafting was performed in the bloody area. Methods: Retrospective analysis of the medical records of the patient in question. This paper follows the Declaration of Helsinki's standards and the approval of the Ethics and Research Committee. Conclusion: The free flap of the large dorsal muscle proved effective in this case of reconstruction of the scalp's extensive lesion (550cm2) with partial periosteum lesion due to scalping. The flap recovered the shape of the skull and the protective function of the skull cap.http://www.rbcp.org.br/export-pdf/2995/en_v36n3a19.pdfplastic surgerymicrosurgeryscalpmyocutaneous flapinjuries and injuries
spellingShingle Daniel Nowicki Kaam
André Coelho Nepomuceno
Gabriel Diniz Nishimura
Fernando Giovanetti Morano
Juliano Pereira
Juliana Gulelmo Staut
Jose Carlos Marques de Faria
Rodrigo Pinto Gimenez
Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
Revista Brasileira de Cirurgia Plástica
plastic surgery
microsurgery
scalp
myocutaneous flap
injuries and injuries
title Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
title_full Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
title_fullStr Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
title_full_unstemmed Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
title_short Scalp reconstruction with large dorsal muscle-free flap after dog bite scalping
title_sort scalp reconstruction with large dorsal muscle free flap after dog bite scalping
topic plastic surgery
microsurgery
scalp
myocutaneous flap
injuries and injuries
url http://www.rbcp.org.br/export-pdf/2995/en_v36n3a19.pdf
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