Published in:
01-04-2015 | Original Paper
Reconstruction of calvarial and scalp defects using anterolateral thigh free flaps: A case series
Published in: European Journal of Plastic Surgery | Issue 2/2015
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Background
Regardless of underlying cause, calvarial and scalp reconstruction can be a challenging task. With increasing defect size, the local options also decrease, and in moderate to large sized defects, a free flap reconstruction is usually required. Since 2007, we have used the anterolateral thigh (ALT) flap as our flap of choice, and we present our results with this flap.
Methods
The study was a retrospective case series in a university hospital setting. All patients who had this procedure performed were included until October 2014, and their data was retrieved from electronic patient records.
Results
In total, eight patients were reconstructed with an ALT flap for calvarial (six) or scalp (two) reconstruction. The flaps used were fasciocutaneous (four), myocutaneous (three), and adipofascial (one). All patients were male with a mean age of 59 years. The median flap length was 22.5 cm and median flap width was 8 cm. All flaps survived. One patient was offered a revision procedure because of color mismatch, but this was cancelled as the patient requested hair transplantation in a private setting. No donor site morbidity was noted in any of the patients.
Conclusions
The ALT flap is very versatile and can be harvested in a number of different ways according to defect requirements. It has minimal donor site morbidity and is the optimal flap option for calvarial and scalp reconstruction, although still insufficient regarding to color mismatch and lack of hair.
Level of Evidence: Level V, therapeutic study