Liječnički vjesnik, Vol. 146 No. 9-10, 2024.
Original scientific paper
https://doi.org/10.26800/LV-146-9-10-2
Local axial flaps in the reconstruction of scalp excision defect in patients of advanced age
Ivan Kovačić
Marijan Kovačić
*
Zoran Kranjčec
* Corresponding author.
Abstract
The aim of this paper is to present the results of the treatment of scalp defect reconstruction after surgical excision of basal cell (BCC) and squamous cell skin carcinoma (PCC) in a group of patients older than 80 years. In the retrospective analysis, we included nine patients who at the time of surgery had a tumor size greater than 4 cm. After their excision, the resulting defects had a wide range from 40 cm2 to 81.7 cm2 (median, C = 63.6 cm2). Their depth reached from the denuded periosteum to the dura mater. All were reconstructed with axial local flaps that were formed through a subgaleal approach with named supply vessels, and tissue transfer was performed by sliding, transposition, and rotation. The donor site was repaired by primary closure or by using a free skin graft. The patients’ recovery was quick, with no general complications. Among the local surgical complications, we recorded infection with marginal necrosis of the junction of the flap and the surrounding tissue with
ecchymosis present in five patients. All these complications were resolved during outpatient wound care. Using axial local flaps, a large excision scalp defect was successfully replaced in a group of patients of advanced age, regardless of their poor skin quality, scars from earlier surgery, and existing comorbidities. This method of reconstruction is not technically demanding, it is performed in one act and we can consider it safe for all levels and localizations of scalp defects.
Keywords
SCALP – surgery; PLASTIC SURGERY PROCEDURES – methods; CARCINOMA, BASAL CELL – surgery; CARCINOMA, SQUAMOUS CELL – surgery; SKIN NEOPLASMS – pathology, surgery; SURGICAL FLAPS; AGED, 80 AND OVER – surgery
Hrčak ID:
322403
URI
Publication date:
18.11.2024.
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