De RDR, González-Guevara M, Manzo-Hernández M, Alegre-Tamez E

Language: Spanish
References: 16
Page: 234-238
PDF size: 272.28 Kb.

ABSTRACT

There are multiple types of local flaps for scalp reconstruction, however, by making an adequate assessment and a suitable design, variants can be made for scalp-type lesions. The objective of this report is to present a surgical technique of major scalp reconstruction and auricular helix abrasion due to extensive injury. We present the case of a 14-year-old female patient who suffers a car accident due to rollover, presenting extensive avulsion of the scalp type in the right temporal fossa of 15 cm plus avulsion of the upper third of the right auricular helix plus multiple facial and body injuries. Debridement of devitalized tissue of the affected area is performed with reconstruction based on locoregional flaps with parieto-occipital and reverse facial rotation flaps. In this technical report the reconstructive and resolutive technique is exposed, the patient presents adequate evolution in the immediate and mediate postoperative period. It is concluded that locoregional flaps up to a certain point within the reconstructive ladder are an excellent reconstructive option in defects greater than 30% of the affected areas in the temporal region with an adequate design of the same.

REFERENCES

1. Baker S. Local flaps in facial reconstruction. 3ed. Philadelphia, Pa: Elsevier Saunders; 2014.

2. Li D, Xu F, Zhang R, Zhang Q, Xu Z, Li Y et al. Surgical reconstruction of traumatic partial ear defects based on a novel classification of defect sizes and surrounding skin conditions. Plast Reconstr Surg. 2016; 138 (2): 307e-316e.

3. Mokal NJ, Ghalme AN, Kothari DS, Desai M. The use of the temporoparietal fascia flap in various clinical scenarios: a review of 71 cases. Indian J Plast Surg. 2013; 46 (3): 493-501.

4. Santander B, García M, Aliaga A. Reconstrucción del pabellón auricular con colgajo retroauricular. Rev Cuadernos. 2006; 51 (2): 70-72.

5. Plaza O. Reconstrucción parcial de pabellón auricular con colgajo retroauricular e injerto. Rev Horiz Med Volumen. 2012; 12 (4): 50-54.

6. Altindas M, Arslan H, Bingol UA, Demiroz A. Prelaminated extended temporoparietal fascia flap without tissue expansion for hemifacial reconstruction. J Plast Reconstr Aesthetic Surg. 2017; 70 (10): 1457-1463.

7. Collar RM, Zopf D, Brown D, Fung K, Kim J. The versatility of the temporoparietal fascia flap in head and neck reconstruction. J Plast Reconstr Aesthet Surg. 2012; 65 (2): 141-148.

8. Yamauchi M, Yotsuyanagi T, Yamashita K, Ikeda K, Urushidate S, Mikami M. The reverse superficial temporal artery flap from the preauricular region, for the small facial defects. J Plast Reconstr Aesthet Surg. 2012; 65 (2): 149-155.

9. Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg. 2005; 116 (4): 54e-72e.

10. Pusic AL, Chen CM, Patel S, Cordeiro PG, Shah JP. Microvascular reconstruction of the skull base: a clinical approach to surgical defect classification and flap selection. Skull Base. 2007; 17 (1): 5-15.

11. Sharma RK, Tuli P. Occipital artery island V-Y advancement flap for reconstruction of posterior scalp defects. J Plast Reconstr Aesthet Surg. 2010; 63 (3): 410-415.

12. Starkman SJ, Williams CT, Sherris DA. Flap basics I: rotation and transposition flaps. Plast Surg Clin North Am. 2017; 25 (3): 313-321.

13. Reinisch JF, van Hovell Tot Westerflier CVA, Tahiri Y, Yao CA. The occipital artery-based fascial flap for ear reconstruction. Plast Reconstr Surg. 2019; 143 (3): 592e-601e.

14. Costa DJ, Walen S, Varvares M, Walker R. Scalp rotation flap for reconstruction of complex soft tissue defects. J Neurol Surg B Skull Base. 2016; 77 (1): 32-37.

15. Lo CH, Kimble FW. The ideal rotation flap: an experimental study. J Plast Reconstr Aesthet Surg. 2008; 61 (7): 754-759.

16. Fowler NM, Futran ND. Achievements in scalp reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2014; 22 (2): 127-130.