scholarly journals Scalp and Forehead Reconstruction

2018 ◽  
Vol 32 (02) ◽  
pp. 090-094 ◽  
Author(s):  
Mofiyinfolu Sokoya ◽  
Jared Inman ◽  
Yadranko Ducic
Keyword(s):  
Surgical Management ◽  
Primary Closure ◽  
Skin Grafting ◽  
Tissue Expanders ◽  
Neurovascular Structure ◽  
Secondary Intention ◽  
Hair Morphology ◽  
Scalp Defects ◽  
Reconstructive Ladder ◽  
Facial Plastic

AbstractReconstructing the scalp and forehead is a challenging endeavor frequently undertaken by facial plastic and reconstructive surgeons. There are many anatomical factors to be considered in this area, including multiple neurovascular structure present that should be identified and preserved. Hair morphology and physiology should be considered, and trichophytic techniques should be incorporated into incision planning and closure. The reconstructive ladder must be used when considering options in reconstructing scalps and forehead defects. This article reviews reconstructive options including secondary intention, primary closure, skin grafting, allografts, tissue expanders, and local, regional, and free tissue transfers, among others in the surgical management of forehead and scalp defects. The reconstructive surgeon should be familiar with these techniques and be able to use them when indicated, based on the size, shape, and location of defects.

scholarly journals Sternocleidomastoid Myocutaneous Flap for Scalp Reconstruction

2019 ◽  
Vol 5 ◽  
pp. 2513826X1982879
Author(s):  
Jin Woo Kim ◽  
Do Hun Kim
Keyword(s):  
Chronic Inflammation ◽  
Primary Closure ◽  
Myocutaneous Flap ◽  
Free Tissue Transfer ◽  
Skin Grafting ◽  
Pedicled Flap ◽  
Scalp Reconstruction ◽  
Scalp Defects ◽  
Scalp Defect ◽  
Defect Area

Scalp defects may occur due to various causes, such as head trauma. For reconstruction of the defect, a primary closure process, skin grafting, or local flap use are the foremost choices when the defect area is not wide. However, repair is difficult when the wound condition further deteriorates due to chronic inflammation. In this condition, free tissue transfer or a pedicled flap is required to restore normal blood supply. The sternocleidomastoid (SCM) flap is conventionally raised as a superiorly or inferiorly based pedicled flap, easily harvested to rectify a nearby scalp defect; additionally, it may either be muscular or myocutaneous. This report describes a case of successful use of the SCM flap for scalp reconstruction, raised as a superiorly based myocutaneous flap.

Excision and Primary Closure May be the Better Option in the Surgical Management of Pilonidal Disease in the Pediatric Population

2016 ◽  
Vol 82 (10) ◽  
pp. 964-967 ◽  
Author(s):  
Jessica A. Zagory ◽  
Jamie Golden ◽  
Kathleen Holoyda ◽  
Natalie Demeter ◽  
Nam X. Nguyen
Keyword(s):  
Length Of Stay ◽  
Surgical Management ◽  
Analysis Of Variance ◽  
Primary Closure ◽  
Average Length ◽  
Pilonidal Disease ◽  
Pediatric Population ◽  
Average Length Of Stay ◽  
Secondary Intention ◽  
Flap Closure

The optimal management of pilonidal disease in the pediatric population is still debated. We conducted a retrospective review of patients 21 years old and younger who underwent surgical management for pilonidal disease between 2009 and 2013 at a single pediatric institution. Sixty patients (41.7% male) were included in the analysis, with a mean age of 15.0 years (range, 13–20). Twelve (20%) had a prior drainage procedure for pilonidal abscess before the definitive operative treatment. After excision to the presacral fascia, 36 (60%) had primary closure, 17 (28.3%) were left to heal by secondary intention, and 7 (11.7%) had flap closure. Overall recurrence rate was 41.7 per cent with 33.3 per cent in the primary, 58.8 per cent in the secondary, and 42.9 per cent in the flap group, respectively. Ten (16.7%) patients developed postoperative complications, which were similar among surgical groups, gender, and body mass index. The average length of stay was 0.67 (median 0, range, 0–5) days. Primary closure had the shortest length of stay (analysis of variance P = 0.04), and flap closure had no reoperations (analysis of variance P < 0.01). Pilonidal disease remains surgically challenging. Our data suggest that excision and primary closure is a better option in the pediatric population.

The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

2013 ◽  
Vol 154 (6) ◽  
pp. 225-227 ◽  
Author(s):  
Csaba Halmy ◽  
Zoltán Nádai ◽  
Krisztián Csőre ◽  
Adrienne Vajda ◽  
Róbert Tamás
Keyword(s):  
Surgical Treatment ◽  
Skin Lesion ◽  
Surgical Management ◽  
Skin Grafting ◽  
Skin Tumor ◽  
Temporal Region ◽  
Aesthetic Result ◽  
Malignant Skin ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

scholarly journals Utility of Shoelace Technique in Closure of Fasciotomy Wounds in Electric Burns

2020 ◽  
Author(s):  
Praveen Kumar Arumugam ◽  
Vamseedharan Muthukumar ◽  
Rahul Bamal
Keyword(s):  
Surface Area ◽  
Wound Closure ◽  
Skin Grafting ◽  
High Volume ◽  
Wound Surface ◽  
Closure Rate ◽  
Secondary Intention ◽  
Resource Limited ◽  
Electric Burns ◽  
Mean Time

Abstract Fasciotomy is indicated to relieve compartment syndrome caused by electric burns. Many techniques are available to close the fasciotomy wounds including vacuum-assisted closure, skin grafting, and healing by secondary intention. This study assessed the shoelace technique in fasciotomy wound closure in patients with electric burns. The study included 19 fasciotomy wounds that were treated by shoelace technique (Group ST, n = 10 fasciotomy wounds) or by skin grafting/healing by secondary intention (Group C, n = 9 fasciotomy wounds). Data were collected for wound surface area, time to intervention, time to wound closure, rate of decrease in wound surface area after application of shoelace technique and associated complications. The mean time to intervention after fasciotomy was significantly lower in Group ST—7.6 ± 3.8 days as compared to 15.8 ± 5.3 days in Group C (P = .004). The median time to closure was also significantly lower in Group ST—7 days (range 6–10) as compared to Group C—20 days (range 12–48) (P &lt; .001). Primary closure was achieved in 80% cases in the group ST and no complications were recorded. The shoelace technique is an economical, fast, and effective method of fasciotomy wound closure in electric burns, especially in high volume centers and resource-limited areas.

scholarly journals Scalp Reconstruction Following High Voltage Electric Burn

2014 ◽  
Vol 3 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Md Zakir Hossain ◽  
Bidhan Sarker ◽  
Lutfar Kader Lenin ◽  
Ayesha Hanna ◽  
Limon Kumar Dhar
Keyword(s):  
Plastic Surgery ◽  
High Voltage ◽  
Skin Grafting ◽  
College Hospital ◽  
Transposition Flap ◽  
Reconstructive Procedures ◽  
Rotation Flap ◽  
Medical College ◽  
Scalp Reconstruction ◽  
Scalp Defects

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52

scholarly journals PILONIDAL SINUS DISEASE: COMPARISON OF EXCISION AND PRIMARY CLOSURE VERSES EXCISION AND HEALING BY SECONDARY INTENTION

1969 ◽  
Vol 2 (1) ◽  
pp. 134-137
Author(s):  
Mohammad Hussain ◽  
Manzoor Ali ◽  
S.M.Naeem ◽  
Nisar Ali ◽  
Muhammad Ismail
Keyword(s):  
Local Excision ◽  
Pilonidal Sinus ◽  
Wide Local Excision ◽  
Primary Closure ◽  
Health Concern ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Secondary Intention ◽  
Group A ◽  
Group B

Introduction: Sacrococcygeal pilonidal disease is a serious health concern because of its associatedcomplications and recurrence. Pilonidal sinus disease is presented with symptoms ranging fromasymptomatic pits to painful draining lesions that are predominantly located in the sacrococcygeal region. Itis characterized by multiple subcutaneous sinuses, containing hairs. The exact etiology of the disease is notknown. Various treatment options are available. The choice of a particular surgical approach depends on thesurgeon's familiarity with the procedure and perceived results. The present study was aimed to compare twotreatment regimens i.e.excision and primary closure verses excision and healing by secondary intention.Patients and methods: The study was conducted in the department of surgery, Saidu Teaching HospitalSaidu Sharif Swat. Forty nine (49) human subjects with informed consent were included in the study.Patients were divided in two groups, depending on their preference and acceptance of the procedure.Patients in group A under went excision of the tract with primary closure of the defect by primary simpleclosure, Rhomboid Limberg flap or by Karydakis procedure. Patients in group B were those in whom sinustracts were excised and wound was left open for healing by secondary intention.Results: Out of the total 49 patients 3 (6.122%) were female. Mean age was 26 years (range 18-40years).Group A comprised of 24 patients in whom wide local excision was performed and wound was closedprimarily while Group B comprised of 25 patients who underwent wide local excision and wound was leftopen for healing by secondary intention. Mean hospital stay of patients in group B was significantly longerthan group A (p=0.002). The mean time for complete healing of the wound after primary closure wasmarkedly shorter.mConclusion: Primary closure of the wound after excision of the sinus tract is preferable over simple excisionand healing by secondary intention.Key words; Pilonidal sinus, primary closure, simple excision.

Augmented Skin Grafting: A New Rung in the Reconstructive Ladder

2021 ◽  
Author(s):  
Kelly C. Landeen ◽  
Seth J. Davis ◽  
Raj D. Dedhia ◽  
Karthik S. Shastri ◽  
William Russell Ries ◽  
...  
Keyword(s):  
Skin Grafting ◽  
Reconstructive Ladder

Pilonidal disease

2021 ◽  
pp. 1213-1222
Author(s):  
Kezia Echlin ◽  
Andrew Fleming
Keyword(s):  
Primary Closure ◽  
Recurrent Disease ◽  
Pilonidal Disease ◽  
Signs And Symptoms ◽  
Natal Cleft ◽  
Secondary Intention ◽  
Pain Disability ◽  
Sacrococcygeal Region ◽  
Pilonidal Abscess ◽  
Flap Closure

Pilonidal disease presents with a range of signs and symptoms: asymptomatic pits in the natal cleft, acute abscesses, chronic disease with persistent, discharging sinuses, or recurrent disease following previous attempts at treatment. It primarily affects the sacrococcygeal region and is a disease of young adults, generally male, and leads to pain, disability, and time lost from work. The treatment for an acute pilonidal abscess is widely accepted to be incision and drainage with the incision placed out of the natal cleft. The treatment of chronic and recurrent disease is contentious with excision and then either healing by secondary intention, primary closure, or flap closure all being suggested alongside other less aggressive approaches aimed at conserving tissue. Currently none of these treatments is ideal, although primary closure in the midline has been shown to be inferior and should not be performed.

Article Commentary: Optimizing Aesthetic Results in Skin Grafting

2012 ◽  
Vol 78 (2) ◽  
pp. 151-154 ◽  
Author(s):  
Ron Hazani ◽  
Ryan Whitney ◽  
Bradon J. Wilhelmi
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Donor Site Morbidity ◽  
Secondary Intention ◽  
Donor Skin ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Sheet Graft ◽  
Surrounding Skin ◽  
Tissue Defects

The aesthetic goal in skin grafting is to provide a cosmetically pleasing coverage of soft tissue defects while minimizing donor site morbidity. A skin graft should blend well with the color and texture of the surrounding skin, reduce wound size, and not interfere with the function of the reconstructed part. This review examines the key components of choosing the appropriate donor skin for a variety of defects. The decision-making process is based on the anatomic location of the defect; donor site availability; and graft size, thickness, and pigmentation. The aesthetic implications of using a sheet graft versus a meshed graft versus an expanded graft are discussed. Aside from addressing the aesthetic needs of the defect, attention is paid to the functional goals of the reconstructed part and reduced donor site morbidity. Partial graft failure can have significant deleterious effects on the aesthetic outcome of skin grafts. The need for further grafting or healing by secondary intention may result in additional scarring and deformity. Recommendations for improvement in graft take and infection control are presented.

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