Single Stage Reconstruction of Large Calvarial Exposure after Tumor Resection: A 3-Year Experience

We aimed to review the treatment and outcome of patients’ undergone recon-struction of large full thickness scalp defects with exposed calvarium after oncologic resection with the combined local flap and split-thickness skin graft (STSG) technique.

A retrospective review of 45 patients with scalp defects secondary to tumor extirpation was performed at the Plastic Surgery Department, Tanta Universi-ty Hospital, Tanta, Egypt from Nov 2016 to Nov 2019. Patients, with large (>50 cm2) and full-thickness (exposed calvarium) scalp defects, who under-went scalp reconstruction with the combined local flap and STSG technique and had completed their medical records were enrolled.

Only 38 met the inclusion criteria. Thirty-three were male (86.8). The mean age was 61.5 years. The lesions removed were BCC in 30 cases (78.9%) and SCC in 8 cases (21.1%). Defect sizes ranged from 55 to 196 cm2. There was complete survival of all flaps. Complications were noticed in 5 patients (13.2%);2 developed small hematomas, 2 suffered from partial graft losses and one had wound infection. The follow-up period ranged from 6 to 27 months. Overall, 34 patients were satisfied with the functional and cosmetic results (89.5%), while 4 female patients werenchr('39')t satisfied with the esthetic results (10.5%).

The combination of local flap and skin graft technique is highly reliable, easy to perform and safe single-stage reconstructive modality of large skull ex-posed scalp defects, providing durable coverage and favorable esthetic out-come.