A study of various reconstructive options and their complications and management of scalp defects

Background: Scalp defects are mainly caused due to trauma, tumour resection and burns. The repair of such defect is dependent upon their location, size and depth Objectives: To study various reconstructive options and their complications and to provide a framework for management of scalp defects Methods: This was a prospective study done on patients who have had scalp defects requiring surgery. Total of 30 patients were included in the study. Tumor histology was confirmed by the pathology department. All patients were followed for 3 to 6 months post operatively. Free Flap was done in six patients. Anterolateral thigh flap and Radial Forearm Free Flap were done. STSG was applied in 9 patients. Tissue expander was applied in 3 patients. Local flaps like rotation, transposition etc was done in 12 patients. Results: Etiology found was Road Traffic accident in majority of patients i.e. 10. Burn and basal cell carcinoma was etiology in 6 patients each. Squamous cell carcinoma was found in 5 patients. Fall from height was etiology in 4 patients. Males were more than females. Free flap was done in six patients. Split thickness skin graft was done in nine patients. Tissue expander was used in three patients. Local flap was used in twelve patients. Three patients had tip necrosis and two patients had infection. Out of three having tip necrosis, two were operated by using free flap with conservative approach. Local flap was used in one patient. Out of two patients with infection, local flap was used in one patient and STSG was used in one. Conclusion: In small to medium sized defect with exposed bone, local flaps are a good option. In large and extensive defects, free flaps should be used.