An Analysis of Different Reconstruction Modalities Utilized for Full Thickness Defects of Scalp

Abstract

Objective: To highlight the use of various reconstruction modalities and to stress the importance
of timely and proper coverage of these defects as otherwise the chances of Marjolin ulcers
increase with the passage of time.
Material & Methods: Atotal of 35 cases included 20 males and 15 females. All the cases which
presented with full thickness soft tissue defects of scalp or where the defect was the result of
excision of some growth were included in the study. Long standing wounds were biopsied to rule
out any chances of malignancy before reconstruction of the defect.
Results: In 11 cases defect was result of burn injury, in nine cases etiology was road traffic
accident, while another group of eight patients had these defects as a result of ablation surgery.
One defect resulted from excision of the arteriovenous malformation and in other flaps necrosed
after a craniotomy. All the treated cases did well. There was partial flap necrosis in one case
caused by excessive tension on the flap. Surgery was deferred in three of the cases as they were
in advanced stage of malignant degeneration in the post burn scar.
Conclusion: Series witnessed a spectrum of options for coverage of soft tissue defects. Every
case needs to be dealt on individual basis for selection of the option. Post burn wounds if not
provided with a proper soft tissue cover may lead to malignant transformation.