ABSTRACT
Aetiology of the scalp defects may be burns, trauma, avulsion, infection, resection for neoplasm or congenital defects, the goals & principles are similar, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. We wanted to assess the epidemiology, etiological factors, type and site of distribution, various modalities, overall cosmetic effect and function of both donor as well as recipient sites of scalp defects. We also wanted to evaluate the epidemiological and aetiological factors influencing the various modalities of scalp defect management and the overall cosmetic effect on both donor as well as recipient site. METHODSA descriptive study was conducted at Sham Shah Medical College and associated SGM Hospital, Rewa, which is also known as Vindhya region of Madhya Pradesh. A total of 44 cases of scalp defects, that were treated in the department of surgery over a period of 18 months from May 2018 to November 2019 constitute the material of this study. Patients were included in the study after obtaining an informed consent. One-year follow-up of the patients was done, RESULTS26 cases [59.01%] of scalp defect were repaired with transposition flap; rotation flap was done in 2 cases [4.45%], bipedicled flap was done in 2 cases [4.45%], double opposing rotational flap was done in 01 case [2.27], S.T.G. was done in 7 cases [15.9%], and primary closure was done in 6 cases [13.63%]. In our study 59.09% cases are due to trauma and occur in second to fourth decade out of which 26 patients have exposed bone, and out of 26 patients, 09 patients have fracture of bone. CONCLUSIONSScalp reconstruction depends on the nature and the region of the defect. A range of reconstruction techniques have been described. The quality of the residual scalp is critical for performing a local flap. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps. The parietal zone is the location offering the greatest flap mobilization possibilities. A review is provided of the different techniques for the reconstruction of large scalp defects.
ABSTRACT
Background: The scalp wounds are becoming increasingly common as a result of high-speed automobile accidents, fall from heights and others. Scalp reconstruction is a challenge for plastic surgeons. Minor wounds heal of themselves, but some wounds need some type of intervention in the form of reconstruction. Authors have raised flaps in unconventional measurements.Methods: Authors have incorporated 19 patients in this study over a period of one year. Extensive surgical procedures like burring of the skull bones and patients with comorbid conditions were not included. Authors simply rely on local flaps preferably transposition flaps to cover mainly the exposed skull bones. All the flaps were raised leaving the galea intact. The secondary defects were always skin grafted with split skin graft taken from thigh. Authors have raised random flaps in unconventional dimensions showing that a large random flap can be raised on a single vessel with good results.Results: All the wounds healed well without significant complications. So, this method of reconstruction can be applied to even large defects where very sophisticated services are not available.Conclusions: This method of reconstruction can be applied to even very large defects where very sophisticated microvascular services and expertise are not available with appreciably good results.
ABSTRACT
Objective To investigate the application of the parietal branches of superficial temporal artery island flap in the complex scalp defects.Methods A parietal branches of superficial temporal artery island flap on the ectatic scalp flap was designed to repair the complex scalp defects in 25cases and the repairing effect was observed.Results The island flaps were survived completely in 24patients,in which 1 patient had partial necrosis because of the flap tension was too large,but healed after local dressing and debridement.After followed up 6～ 12 months,the color and texture of the flap were the same to the surrounding normal scalp,and the shape was satisfactory.The flap donor site of hair growth was good,with well healing and no obvious complications.Conclusions The parietal branches of superficial temporal artery island flap can repair the complex scalp defects with the flexible flap design and movement.The flap survives well and the repair area is large.The flap and the surrounding scalp connects good.Therefore,it is a good method strongly recommended for small area complex scalp defects repair in clinics.
ABSTRACT
A aplasia cutis é uma doença rara, caracterizada pela ausência congênita da epiderme e da derme. Os autores relatam o caso de R.L.M., nascida em29.05.97, sexo feminino, com 2.970g, perímetro cefálico de 31 cm,apresentando falha no couro cabeludo, na região parietal posterior, estendendose bilateralmente, com cerca de 8 cm x 4 cm, de consistência amolecida, coloração avermelhada, aspecto de membrana meníngea bem vascularizada, caracterizando a aplasia cutis. Aparentemente, nenhuma outra anomalia congênita estava presente. Foram aplicadas sulfadiazina de prata e solução salina local, com vestimento da lesão. Após 25 dias, houve fechamento quase completo da lesão. Após um ano de terapêutica, a lesão encontrava-se completamente fechada. Conclui-se que o tratamento proposto parece eficaz. Entretanto, mesmo com boa evolução, tais pacientes necessitam de acompanhamento rigoroso, tendo em vista as possíveis complicações, a existência de anomalias associadas e a eventual necessidade de realização de cranioplastia.
The authors present a case of aplasia cutis of the scalp. This case wasassociated with cranium malformation. The patient was treated conservativelywith the use of Silvadene cream dressing. Healing was obtained about the 30th day of the treatment. We conclude that Silvadene should be considered as apossible treatment to aplasia cutis.