Modified Unilateral Pedicled V-Y Advancement Flap for Scalp Defect Repair:

Basal cell carcinoma of the scalp: surgical approach and reconstructive options

INTRODUCTION

Surgical therapy of basal cell carcinomas (BCC) is based on complete excision of the neoplasm and its immediate suitable reconstruction. The aim of this work was to evaluate the possibility of creating a reconstructive algorithm in cases of scalp BCC, depending on the amplitude of the tumor.

EVIDENCE ACQUISITION

A literature search was carried out using the databases of PubMed, Scopus and Cochrane.

EVIDENCE SYNTHESIS

Based on the experiences reported in the literature, it was possible to structure a decision-making algorithm that summarizes the various steps involved in the choice of the most suitable reconstructive surgical therapy.

CONCLUSIONS

The algorithm described we hope will be of reference or help to less experienced reconstructive plastic surgeons.

Management of Scalp Injuries

Soft tissue wounds in the scalp are a common occurrence after trauma or resection of a malignancy. The reconstructive surgeon should strive to use the simplest reconstructive technique while optimizing aesthetic outcomes. In general, large defects with infection, previous irradiation (or require postoperative radiation), or with calvarial defects usually require reconstruction with vascularized tissue (ie, microvascular free tissue transfer). Smaller defects greater than 3 cm that are not amenable to primary closure can be treated with local flap reconstruction. In all cases, the reconstruction method will need be tailored to the patient's health status, desires, and aesthetic considerations.