Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Cleft Palate-Craniofacial Association
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556891/ https://www.ncbi.nlm.nih.gov/pubmed/28913317 http://dx.doi.org/10.7181/acfs.2017.18.2.112 |
_version_ | 1783257146621689856 |
---|---|
author | Kim, Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha |
author_facet | Kim, Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha |
author_sort | Kim, Youn Hwan |
collection | PubMed |
description | The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft. Unfortunately, the flap became completely useless and a bilateral rotation flap was used to cover the defect. Two month later, seroma with infection was found due to recurrence of the tumor. Additional surgery was performed using multiple perforator based island flap. The patient was discharged two weeks after surgery without any complications, but two months later, the patient died. Radical surgical resection of tumor is the most important curative option, followed by functional and aesthetic reconstruction. We describe a patient with a highly malignant tumor that required multiple resections and subsequent reconstruction. Repeated recurrences of the tumor led to the failure of reconstruction and our strategy inevitably changed, from reconstruction to palliative treatment involving fast and stable wound closure for the patient's comfort. |
format | Online Article Text |
id | pubmed-5556891 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | The Korean Cleft Palate-Craniofacial Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-55568912017-09-14 Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy Kim, Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Arch Craniofac Surg Case Report The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft. Unfortunately, the flap became completely useless and a bilateral rotation flap was used to cover the defect. Two month later, seroma with infection was found due to recurrence of the tumor. Additional surgery was performed using multiple perforator based island flap. The patient was discharged two weeks after surgery without any complications, but two months later, the patient died. Radical surgical resection of tumor is the most important curative option, followed by functional and aesthetic reconstruction. We describe a patient with a highly malignant tumor that required multiple resections and subsequent reconstruction. Repeated recurrences of the tumor led to the failure of reconstruction and our strategy inevitably changed, from reconstruction to palliative treatment involving fast and stable wound closure for the patient's comfort. The Korean Cleft Palate-Craniofacial Association 2017-06 2017-06-26 /pmc/articles/PMC5556891/ /pubmed/28913317 http://dx.doi.org/10.7181/acfs.2017.18.2.112 Text en Copyright © 2017 The Korean Cleft Palate-Craniofacial Association http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Kim, Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title | Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title_full | Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title_fullStr | Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title_full_unstemmed | Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title_short | Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy |
title_sort | reconstruction of a complex scalp defect after the failure of free flaps: changing plans and strategy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556891/ https://www.ncbi.nlm.nih.gov/pubmed/28913317 http://dx.doi.org/10.7181/acfs.2017.18.2.112 |
work_keys_str_mv | AT kimyounhwan reconstructionofacomplexscalpdefectafterthefailureoffreeflapschangingplansandstrategy AT kimgyeonghoe reconstructionofacomplexscalpdefectafterthefailureoffreeflapschangingplansandstrategy AT kimsangwha reconstructionofacomplexscalpdefectafterthefailureoffreeflapschangingplansandstrategy |