ePlasty: Vol. 14
Evaluation of Options for Large Scalp Defect Reconstruction: A 12-Year Experience
Dustin L. Eck, MD,a Stephanie L. Koonce, MD,a Bader M. Al Majed, MD,b and Galen Perdikis, MDb

aDepartments of General Surgery; and bPlastic Surgery, Mayo Clinic, Jacksonville, Fla

Correspondence: perdikis.galen@mayo.edu
Keywords: free flap, local tissue flap, microsurgery, scalp defects, scalp reconstruction

Objective: Multiple options for reconstruction of scalp defects exist with local tissue advancement and free tissue transfer the mainstay of reconstruction. Over the last 12 years, our tertiary referral hospital has performed more than 150 scalp reconstructions. We reviewed our experience with large scalp defects and evaluated whether free tissue transfer is a viable first option for reconstruction. Methods: A retrospective review was conducted of all scalp reconstructions from January 1, 1999, to December 31, 2011. A cohort of patients with defects greater than 50 cm2 were identified for a total of 64 operations; 10 free flaps, 28 local advancement flaps, and 26 skin grafts. Reoperation rates and complications were compared between groups. Results: Reoperation rate in the free flap group was 20% (2/10). Both reoperations were within the immediate postoperative period, one for microvascular thrombotic occlusio .......