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Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience

Background: Complex scalp defects are regularly reconstructed using microvascular tissue transfer. The latissimus dorsi free flap is one of the workhorse flaps used in scalp reconstruction. These cases necessitate, particularly in the elderly, a close cooperation between plastic surgeons and neurosu...

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Autores principales: Strübing, Felix, Wenz, Fabian, Etminan, Nima, Bigdeli, Amir K., Siegwart, Laura C., Thomas, Benjamin, Vollbach, Felix, Vogelpohl, Julian, Kneser, Ulrich, Gazyakan, Emre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142007/
https://www.ncbi.nlm.nih.gov/pubmed/37109289
http://dx.doi.org/10.3390/jcm12082953
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author Strübing, Felix
Wenz, Fabian
Etminan, Nima
Bigdeli, Amir K.
Siegwart, Laura C.
Thomas, Benjamin
Vollbach, Felix
Vogelpohl, Julian
Kneser, Ulrich
Gazyakan, Emre
author_facet Strübing, Felix
Wenz, Fabian
Etminan, Nima
Bigdeli, Amir K.
Siegwart, Laura C.
Thomas, Benjamin
Vollbach, Felix
Vogelpohl, Julian
Kneser, Ulrich
Gazyakan, Emre
author_sort Strübing, Felix
collection PubMed
description Background: Complex scalp defects are regularly reconstructed using microvascular tissue transfer. The latissimus dorsi free flap is one of the workhorse flaps used in scalp reconstruction. These cases necessitate, particularly in the elderly, a close cooperation between plastic surgeons and neurosurgeons. The purpose of this study was to evaluate the suitability of the latissimus dorsi free flap for complex scalp reconstructions and to analyze potential risk factors. Methods: A retrospective study identified 43 patients undergoing complex scalp reconstruction using a latissimus dorsi free flap at our department between 2010 and 2022. Results: The mean patient age was 61 ± 18 years. Defects were mostly caused by oncologic tumor resections (n = 23; 55%), exposure to a cranioplasty (n = 10; 23%) or infection (n = 4; 9%). The most frequent recipient vessels were the superficial temporal artery (n = 28; 65%), external carotid artery (n = 12; 28%) and the venae comitantes (n = 28; 65%), external jugular vein (n = 6; 14%). The reconstructive success rate was 97.7%. There was one total flap loss (2%). Partial flap loss occurred in five cases (12%). Follow-up was 8 ± 12 months. Major complications were seen in 13 cases, resulting in a revision rate of 26%. Multivariate logistic regression identified active tobacco use as the only risk factor for major complications (odds ratio 8.9; p = 0.04). Conclusion: Reconstruction of complex scalp defects using the latissimus dorsi free flap yielded high success rates. Among the potential risk factors, active tobacco use seems to affect the outcome of complex scalp reconstructions.
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spelling pubmed-101420072023-04-29 Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience Strübing, Felix Wenz, Fabian Etminan, Nima Bigdeli, Amir K. Siegwart, Laura C. Thomas, Benjamin Vollbach, Felix Vogelpohl, Julian Kneser, Ulrich Gazyakan, Emre J Clin Med Article Background: Complex scalp defects are regularly reconstructed using microvascular tissue transfer. The latissimus dorsi free flap is one of the workhorse flaps used in scalp reconstruction. These cases necessitate, particularly in the elderly, a close cooperation between plastic surgeons and neurosurgeons. The purpose of this study was to evaluate the suitability of the latissimus dorsi free flap for complex scalp reconstructions and to analyze potential risk factors. Methods: A retrospective study identified 43 patients undergoing complex scalp reconstruction using a latissimus dorsi free flap at our department between 2010 and 2022. Results: The mean patient age was 61 ± 18 years. Defects were mostly caused by oncologic tumor resections (n = 23; 55%), exposure to a cranioplasty (n = 10; 23%) or infection (n = 4; 9%). The most frequent recipient vessels were the superficial temporal artery (n = 28; 65%), external carotid artery (n = 12; 28%) and the venae comitantes (n = 28; 65%), external jugular vein (n = 6; 14%). The reconstructive success rate was 97.7%. There was one total flap loss (2%). Partial flap loss occurred in five cases (12%). Follow-up was 8 ± 12 months. Major complications were seen in 13 cases, resulting in a revision rate of 26%. Multivariate logistic regression identified active tobacco use as the only risk factor for major complications (odds ratio 8.9; p = 0.04). Conclusion: Reconstruction of complex scalp defects using the latissimus dorsi free flap yielded high success rates. Among the potential risk factors, active tobacco use seems to affect the outcome of complex scalp reconstructions. MDPI 2023-04-19 /pmc/articles/PMC10142007/ /pubmed/37109289 http://dx.doi.org/10.3390/jcm12082953 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Strübing, Felix
Wenz, Fabian
Etminan, Nima
Bigdeli, Amir K.
Siegwart, Laura C.
Thomas, Benjamin
Vollbach, Felix
Vogelpohl, Julian
Kneser, Ulrich
Gazyakan, Emre
Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title_full Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title_fullStr Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title_full_unstemmed Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title_short Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience
title_sort scalp reconstruction using the latissimus dorsi free flap: a 12-year experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142007/
https://www.ncbi.nlm.nih.gov/pubmed/37109289
http://dx.doi.org/10.3390/jcm12082953
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