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Microsurgical Reconstruction of Extensive Oncological Scalp Defects

Although most small to medium defects of the scalp can be covered by local flaps, large defects or complicating factors, such as a history of radiotherapy, often require a microsurgical reconstruction. Several factors need to be considered in such procedures. A sufficient preoperative planning is ba...

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Autores principales: Goertz, Ole, von der Lohe, Leon, Martinez-Olivera, Ramón, Daigeler, Adrien, Harati, Kamran, Hirsch, Tobias, Lehnhardt, Marcus, Kolbenschlag, Jonas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588120/
https://www.ncbi.nlm.nih.gov/pubmed/26484347
http://dx.doi.org/10.3389/fsurg.2015.00044
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author Goertz, Ole
von der Lohe, Leon
Martinez-Olivera, Ramón
Daigeler, Adrien
Harati, Kamran
Hirsch, Tobias
Lehnhardt, Marcus
Kolbenschlag, Jonas
author_facet Goertz, Ole
von der Lohe, Leon
Martinez-Olivera, Ramón
Daigeler, Adrien
Harati, Kamran
Hirsch, Tobias
Lehnhardt, Marcus
Kolbenschlag, Jonas
author_sort Goertz, Ole
collection PubMed
description Although most small to medium defects of the scalp can be covered by local flaps, large defects or complicating factors, such as a history of radiotherapy, often require a microsurgical reconstruction. Several factors need to be considered in such procedures. A sufficient preoperative planning is based on adequate imaging of the malignancy and a multi-disciplinary concept. Several flaps are available for such reconstructions, of which the latissimus dorsi and anterior-lateral thigh flaps are the most commonly used ones. In very large defects, combined flaps, such as a parascapular/latissimus dorsi flaps, can be highly useful or necessary. The most commonly used recipient vessels for microsurgical scalp reconstructions are the superficial temporal vessels, but various other feasible choices exist. If the concomitant veins are not sufficient, the jugular veins represent a safe back-up alternative but require a vessel interposition or long pedicle. Post-operative care and patient positioning can be difficult in these patients but can be facilitated by various devices. Overall, microsurgical reconstruction of large scalp defects is a feasible undertaking if the mentioned key factors are taken into account.
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spelling pubmed-45881202015-10-19 Microsurgical Reconstruction of Extensive Oncological Scalp Defects Goertz, Ole von der Lohe, Leon Martinez-Olivera, Ramón Daigeler, Adrien Harati, Kamran Hirsch, Tobias Lehnhardt, Marcus Kolbenschlag, Jonas Front Surg Surgery Although most small to medium defects of the scalp can be covered by local flaps, large defects or complicating factors, such as a history of radiotherapy, often require a microsurgical reconstruction. Several factors need to be considered in such procedures. A sufficient preoperative planning is based on adequate imaging of the malignancy and a multi-disciplinary concept. Several flaps are available for such reconstructions, of which the latissimus dorsi and anterior-lateral thigh flaps are the most commonly used ones. In very large defects, combined flaps, such as a parascapular/latissimus dorsi flaps, can be highly useful or necessary. The most commonly used recipient vessels for microsurgical scalp reconstructions are the superficial temporal vessels, but various other feasible choices exist. If the concomitant veins are not sufficient, the jugular veins represent a safe back-up alternative but require a vessel interposition or long pedicle. Post-operative care and patient positioning can be difficult in these patients but can be facilitated by various devices. Overall, microsurgical reconstruction of large scalp defects is a feasible undertaking if the mentioned key factors are taken into account. Frontiers Media S.A. 2015-09-30 /pmc/articles/PMC4588120/ /pubmed/26484347 http://dx.doi.org/10.3389/fsurg.2015.00044 Text en Copyright © 2015 Goertz, von der Lohe, Martinez-Olivera, Daigeler, Harati, Hirsch, Lehnhardt and Kolbenschlag. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Goertz, Ole
von der Lohe, Leon
Martinez-Olivera, Ramón
Daigeler, Adrien
Harati, Kamran
Hirsch, Tobias
Lehnhardt, Marcus
Kolbenschlag, Jonas
Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title_full Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title_fullStr Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title_full_unstemmed Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title_short Microsurgical Reconstruction of Extensive Oncological Scalp Defects
title_sort microsurgical reconstruction of extensive oncological scalp defects
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588120/
https://www.ncbi.nlm.nih.gov/pubmed/26484347
http://dx.doi.org/10.3389/fsurg.2015.00044
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