Reconstruction of Postinfected Scalp Defects Using Latissimus Dorsi Perforator and Myocutaneous Free Flaps

2012 ◽  
Vol 23 (6) ◽  
pp. 1615-1619 ◽  
Author(s):  
Sang Wha Kim ◽  
Kyu Tae Hwang ◽  
Jong Do Kim ◽  
Youn Hwan Kim
Keyword(s):  
Latissimus Dorsi ◽  
Free Flaps ◽  
Scalp Defects

scholarly journals Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps

2021 ◽  
Vol 10 (17) ◽  
pp. 3863
Author(s):  
José Luis del Castillo Pardo de Vera ◽  
Carlos Navarro Cuéllar ◽  
Ignacio Navarro Cuéllar ◽  
José Luis Cebrián Carretero ◽  
Sandra Bacián Martínez ◽  
...  
Keyword(s):  
Latissimus Dorsi ◽  
Free Flaps ◽  
Team Approach ◽  
Vascular Pedicle ◽  
Scalp Reconstruction ◽  
Scalp Defects ◽  
Anterolateral Thigh ◽  
Oncologic Patients ◽  
The Aesthetic ◽  
Alt Flap

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects.

Resident training in head and neck flap reconstruction in U.S. academic otolaryngology programmes

2001 ◽  
Vol 115 (2) ◽  
pp. 119-121 ◽  
Author(s):  
Mahesh H. Bhaya ◽  
Gady Har-El
Keyword(s):  
Head And Neck ◽  
Latissimus Dorsi ◽  
Pearson Correlation ◽  
Inverse Correlation ◽  
Free Flaps ◽  
Resident Training ◽  
Flap Reconstruction ◽  
Pedicled Flaps ◽  
Significant Difference ◽  
Radial Forearm

The main objective of this study was to assess resident training in head and neck flap reconstruction, and to determine the confidence of graduating residents in performing these flaps independently. Questionnaires were distributed to otolaryngology residents graduating in 1997. Respondents recorded the number of pedicled and free flap procedures they performed, or assisted with, and indicated flaps they felt confident about performing independently.Pectoralis major myocutaneous (PMMC) (n = 560, mean 6.59) and radial forearm (RF) (66, 0.78) were the most common pedicled and free flaps performed. There was a significant difference (p = 0.0002, Mann-Whitney U test) between median confidence for pedicled (44.5 per cent) and free flaps (two per cent). Ten of the 17 flaps showed a significant Pearson correlation (p<0.05) between number of procedures performed and confidence in performing them independently. Of the pedicled flaps, latissimus dorsi (LD) showed good correlation (r = 0.67), PMMC showed low correlation (r = 0.19) and other pedicled flaps fair correlation. Of the free flaps, LD (r = 0.64) and fibula (r = 0.50) showed good correlation and rectus abdominis and RF fair correlation. There was a fair inverse correlation (r =−0.29) between numbers of pedicled and free flaps performed.Higher correlation in flaps uncommonly performed reflects greater operative training necessary to achieve the confidence for performing these flaps independently. As respondents perfomed greater numbers of free flaps, the number of pedicled flaps decreased. It might thus be important to train residents in all aspects of pedicled flaps. Most respondents were of the opinion that additional training in free flaps was necessary for those planning a career in head and neck reconstructive surgery.

Lessons Learned Reconstructing Complex Scalp Defects Using Free Flaps and a Cranioplasty in One Stage

2010 ◽  
Vol 21 (4) ◽  
pp. 1205-1209 ◽  
Author(s):  
Ahmed M. Afifi ◽  
Risal S. Djohan ◽  
Warren Hammert ◽  
Frank A. Papay ◽  
Addison E. Barnett ◽  
...  
Keyword(s):  
Free Flaps ◽  
Lessons Learned ◽  
One Stage ◽  
Scalp Defects

scholarly journals Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
F. Contedini ◽  
L. Negosanti ◽  
E. Fabbri ◽  
V. Pinto ◽  
B. Tavaniello ◽  
...  
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Salvage Procedure ◽  
Soft Tissue Defects ◽  
Vascular Thrombosis ◽  
Flap Failure ◽  
Tissue Defects

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

Reconstruction of maxillectomy and midfacial defects using latissimus dorsi-scapular free flaps in a comprehensive cancer center

Oral Oncology ◽  
2019 ◽  
Vol 99 ◽  
pp. 104468
Author(s):  
A. Moya-Plana ◽  
M. Veyrat ◽  
J.F. Honart ◽  
K. de Fremicourt ◽  
H. Alkhashnam ◽  
...  
Keyword(s):  
Latissimus Dorsi ◽  
Free Flaps ◽  
Comprehensive Cancer Center ◽  
Cancer Center

scholarly journals Free Tissue Reconstruction of the Scalp

2019 ◽  
Vol 33 (01) ◽  
pp. 067-071 ◽  
Author(s):  
Mofiyinfolu Sokoya ◽  
Emily Misch ◽  
Aurora Vincent ◽  
Weitao Wang ◽  
Sameep Kadakia ◽  
...  
Keyword(s):  
Free Tissue Transfer ◽  
Free Flaps ◽  
Advantages And Disadvantages ◽  
Scalp Reconstruction ◽  
Tissue Transfer ◽  
Scalp Defects ◽  
Calvarial Defects ◽  
Reconstructive Option ◽  
Tissue Reconstruction

AbstractReconstruction of scalp defects can be accomplished by many methods, but larger defects, especially those in which the periosteum is absent or calvarial defects are present, require free tissue transfer. Various methods of scalp reconstruction, as guided by the defect components and size, are presented herein, with a focus on free tissue transfer. Different free flaps for scalp reconstructed are described with a comparison of their advantages and disadvantages. Overall, free tissue transfer for scalp defects provides a reliable, durable, and cosmetically adequate reconstructive option.

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