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...

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Autores principales: Kim, Youn Hwan, Kim, Gyeong Hoe, Kim, Sang Wha
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
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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.
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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
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