Use of the O-Z Flap to Repair Scalp Defects After Cancer Tumor Resection

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.

Question Mark Reconstruction Method for Synchronous Multiple Tumor Defects in the Scalp

INTRODUCTION

Synchronous tumors on the scalp are a common condition, and reconstruction methods of their defects should be considered together. The authors believe that the rotation flap combined with the Burow triangle, whose final scar looks like a question mark, can provide excellent results for suitable multiple tumor defects.

MATERIALS AND METHODS

From September 2022 to June 2023, the question mark reconstruction method was performed on 8 patients.

RESULTS

The mean age of the patients was 74.1 years (range, 69-80 y). All tumors were removed with sufficient negative margins. Hair-bearing skin was preserved in all patients, with only a narrow and acceptable scarred alopecic area.

DISCUSSION

The question mark reconstruction method can provide excellent results for synchronous scalp defects by minimizing dog-ear deformity and unnecessary tissue excision and providing a "like-with-like" reconstruction.

Bishop Flap and Sigma Flap to Repair Surgical Defects in High-Tension Anatomical Regions

BACKGROUND

The reconstruction of surgical defects in high-tension anatomical regions is challenging due to the ischemia and subsequent necrosis associated with tension closure. Research on new flaps capable of closing these defects exerting less tension would be a tremendous advancement in dermatological surgery.

PATIENTS AND METHODS

We conducted a multicenter, retrospective study that used 2 new flaps-the bishop and the sigma ones-to repair surgical defects in high-tension regions such as the scalp, lower extremities, and the nasal pyramid. The bishop flap was used in 9 patients, 5 of whom exhibited their lesion in the nasal pyramid, 2 in the legs and another 2 in the scalp. The sigma flap was used in 6 patients, 5 of whom exhibited scalp lesions and 1 leg lesion.

RESULTS

Uneventful and excellent results were obtained in all 15 patients due to infection, dehiscence, or necrosis.

CONCLUSIONS

Both the bishop and the sigma flaps are a good alternative to repair surgical defects in high-tension regions such as the scalp, lower extremities, or the nasal pyramid.

A Hollow Tridimensional Silicone Template for Microtia Reconstruction and Postoperative Scar Compression

Microtia poses a great challenge in auricular reconstruction, due to a great number of anatomical details on the anterior aspect, and its tridimensional shape. Numerous techniques have been described in an attempt to optimize results. We have designed a hollow tridimensional silicon template to serve as an intrasurgical guide for ear's anatomy, size and projection, according to the normal side, which allows better results of auricular reconstruction. It also can be used as a customized post-operative compression method. We believe it could be a valuable tool for microtia reconstruction surgery. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .