Standing on the shoulder of giants: Tubed pedicle radial forearm flap reconstruction for cutis aplasia

INTRODUCTION: Aplasia cutis congenita presents a reconstructive challenge. We report the use of a tube pedicle radial forearm flap for scalp resurfacing in a patient who previously had two failed free flaps. CASE REPORT: A young male patient with cutis aplasia presented with a large full thickness defect of his occiput. He had multiple episodes of recurrent infections and a history of numerous surgeries as a child including tissue expansions. As a young adult he had two failed free flap reconstructions. A CT angiogram failed to demonstrate any adequate bloody supply to the scalp that would be suitable for another free tissue transfer. We successfully performed a tube pedicled flap from his forearm achieving good functional and aesthetic results. CONCLUSION: Originally descried by Filatov, the tube pedicle flaps remains a useful salvage option in the armamentarium of modern-day reconstruction.