ePlasty: Vol. 11
Single-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft
Yoon S. Chun, MD,a and Kapil Verma, BAb

aDivision of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital/Faulkner Hospital, Boston, MA; and bHarvard Medical School, Boston, MA

Correspondence: ychun@partners.org

Full-thickness scalp defects with exposed calvarium pose a reconstructive challenge, particularly in patients with extensive comorbidities. A single-stage acellular dermal matrix and split-thickness skin graft reconstruction represents a simple and valuable surgical approach to achieving durable scalp coverage without requiring a donor-site or prolonged treatment. Reconstruction of full-thickness scalp defects with exposed calvarium is a difficult problem that generally requires local or free flap reconstruction. However, patients with significant medical comorbidities present a further challenge given the risks of a major surgical procedure. Simple skin graft directly onto bone frequently fails and does not provide durable coverage, while combined artificial skin substitute and split-thickness skin graft approach involves a prolonged treatment period with multiple-staged procedures. Herein, we present a case of an 82-year-old female patient with complex medical comorbidities with a large scalp defect and calvarial exposure following Moh's surgery. She was successfully treated with a single-stage acellular dermal matrix and a STSG reconstruction. Her treat .......