Scalp and Calvarial Reconstruction

Overview

Journal Semin Plast Surg

Specialty General Surgery

Date 2010 Jun 23

PMID 20567704

Citations 15

Authors

Samuel J Lin

Matthew M Hanasono

Roman J Skoracki

Affiliations

Soon will be listed here.

Abstract

Over the past several decades, an improved understanding of the blood supply of local flaps, increased experience with tissue expansion, and the development of techniques for microsurgical transfer of distant flaps have greatly contributed to the ability of plastic surgeons to repair scalp defects. This article will review basic anatomy, principles, and pearls of reconstruction for simple to complex scalp defects. Included will be anatomic considerations, indications and contraindications for reconstruction, and an overview of reconstructive options.

Citing Articles

Scalp Incisions With Stairstep Pericranial Edges to Minimize Sequalae from Poor Wound Healing in Supratentorial Brain Tumor Surgery: A Technical Note With Early Results.

Popp N, Singhal I, Laing B, Krucoff K, Krucoff M Neurosurg Pract. 2025; 4(4):e00052.

PMID: 39959395 PMC: 11810015. DOI: 10.1227/neuprac.0000000000000052.

Scalp and Forehead Reconstruction following Mohs Micrographic Surgery.

Mohan V, Leonovicz O, Schmidt J, Gillipelli S, Parham M, Layon S Semin Plast Surg. 2024; 38(4):268-278.

PMID: 39697407 PMC: 11651877. DOI: 10.1055/s-0044-1792105.

Bilateral Transposition Flaps With Split-Thickness Skin Grafting of Secondary Defects After a Large Mohs Micrographic Surgery Defect With Exposed Calvarium.

Freeman S, Neill B, Garvey C, Leitenberger J Cureus. 2023; 15(7):e42191.

PMID: 37602082 PMC: 10439768. DOI: 10.7759/cureus.42191.

Reconstruction of Scalp and Forehead Defects: Options and Strategies.

Krishna D, Khan M, Dubepuria R, Chaturvedi G, Prakash Rao Cheruvu V Cureus. 2023; 15(7):e41479.

PMID: 37551215 PMC: 10404163. DOI: 10.7759/cureus.41479.

The 1-2-3 cm Advancement Flap Rule in Scalp Reconstruction.

Shash H, Marzouq S, Alghamdi A, Alrayes M, Alkhaldi S, Shash H Cureus. 2023; 15(2):e35301.

PMID: 36994305 PMC: 10042496. DOI: 10.7759/cureus.35301.

References

Ozkan O, Coskunfirat O, Ozgentas H, Derin A . Rationale for reconstruction of large scalp defects using the anterolateral thigh flap: structural and aesthetic outcomes. J Reconstr Microsurg. 2005; 21(8):539-45. DOI: 10.1055/s-2005-922433. View

Lutz B, Wei F, Chen H, Lin C, Wei C . Reconstruction of scalp defects with free flaps in 30 cases. Br J Plast Surg. 1998; 51(3):186-90. DOI: 10.1054/bjps.1997.0182. View

Hussussian C, Reece G . Microsurgical scalp reconstruction in the patient with cancer. Plast Reconstr Surg. 2002; 109(6):1828-34. DOI: 10.1097/00006534-200205000-00008. View

Ioannides C, Fossion E, McGrouther A . Reconstruction for large defects of the scalp and cranium. J Craniomaxillofac Surg. 1999; 27(3):145-52. DOI: 10.1016/s1010-5182(99)80042-0. View

Lesavoy M, Dubrow T, Schwartz R, Wackym P, Eisenhauer D, McGuire M . Management of large scalp defects with local pedicle flaps. Plast Reconstr Surg. 1993; 91(5):783-90. DOI: 10.1097/00006534-199304001-00005. View

Arnold P, Rangarathnam C . Multiple-flap scalp reconstruction: Orticochea revisited. Plast Reconstr Surg. 1982; 69(4):605-13. DOI: 10.1097/00006534-198204000-00003. View

Baker S, Swanson N . Tissue expansion of the head and neck. Indications, technique, and complications. Arch Otolaryngol Head Neck Surg. 1990; 116(10):1147-53. DOI: 10.1001/archotol.1990.01870100041009. View

Raposio E, Nordstrom R, Santi P . Undermining of the scalp: quantitative effects. Plast Reconstr Surg. 1998; 101(5):1218-22. DOI: 10.1097/00006534-199804050-00007. View

Pennington D, Stern H, Lee K . Free-flap reconstruction of large defects of the scalp and calvarium. Plast Reconstr Surg. 1989; 83(4):655-61. DOI: 10.1097/00006534-198904000-00010. View

10.

Tolhurst D, Carstens M, Greco R, Hurwitz D . The surgical anatomy of the scalp. Plast Reconstr Surg. 1991; 87(4):603-12; discussion 613-4. View

11.

Losken A, Carlson G, Culbertson J, Hultman C, Kumar A, Jones G . Omental free flap reconstruction in complex head and neck deformities. Head Neck. 2002; 24(4):326-31. DOI: 10.1002/hed.10082. View

12.

Orticochea M . New three-flap reconstruction technique. Br J Plast Surg. 1971; 24(2):184-8. DOI: 10.1016/s0007-1226(71)80038-3. View

13.

Hoffman J . Management of scalp defects. Otolaryngol Clin North Am. 2001; 34(3):571-82. DOI: 10.1016/s0030-6665(05)70006-2. View

14.

Cheng K, Zhou S, Jiang K, Wang S, Dong J, Huang W . Microsurgical replantation of the avulsed scalp: report of 20 cases. Plast Reconstr Surg. 1996; 97(6):1099-106; discussion 1107-8. DOI: 10.1097/00006534-199605000-00001. View

15.

Manders E, GRAHAM 3rd W, Schenden M, Davis T . Skin expansion to eliminate large scalp defects. Ann Plast Surg. 1984; 12(4):305-12. DOI: 10.1097/00000637-198404000-00001. View

16.

van Rappard J, Molenaar J, Van Doorn K, Sonneveld G, BORGHOUTS J . Surface-area increase in tissue expansion. Plast Reconstr Surg. 1988; 82(5):833-9. DOI: 10.1097/00006534-198811000-00016. View

17.

Leedy J, Janis J, Rohrich R . Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg. 2005; 116(4):54e-72e. DOI: 10.1097/01.prs.0000179188.25019.6c. View

18.

Lipa J, Butler C . Enhancing the outcome of free latissimus dorsi muscle flap reconstruction of scalp defects. Head Neck. 2004; 26(1):46-53. DOI: 10.1002/hed.10338. View

19.

Manson P, Crawley W, HOOPES J . Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material. Plast Reconstr Surg. 1986; 77(6):888-904. View

20.

Newman M, Hanasono M, Disa J, Cordeiro P, Mehrara B . Scalp reconstruction: a 15-year experience. Ann Plast Surg. 2004; 52(5):501-6. DOI: 10.1097/01.sap.0000123346.58418.e6. View