A Large Scalp Defect Coverage With Pedicled Free Flap Using the Wrist as a Free Flap Carrier

Inhoe Ku, Taewoon Kim, Kyujin Choi, Hyoungmin Na, Janghyuk Lee, Euicheol Jeong

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The absence of an adequate recipient vessel for free flap pedicle anastomosis near local defect sites discourages surgeons from performing free flap transfers over the scalp because of the challenging neck dissection and the thrombogenic potential of vein grafts for pedicle elongation. We present a case in which a large scalp defect was successfully reconstructed using the wrist as a "free flap carrier," which is an alternative method. A 78-year-old patient with a totally occluded common carotid artery presented to our clinic with a large scalp defect. Reconstruction of the scalp defect was performed in a 2-stage procedure. In the first stage, a free latissimus dorsi (LD) muscle flap was transferred to the defect site, and the pedicle anastomosis was held at the ipsilateral wrist to provide inflow and outflow of blood through the radial artery and vena comitante and cephalic vein that were anastomosed to the flap pedicle. After subsequent split-thickness skin graft, the elevated position of the arm was achieved using a splint and sutures for 3 weeks. In the second stage, the flap was divided, and an additional skin graft over the flap division site and radial artery repair with vein graft was performed. Successful coverage of the scalp defect was confirmed on postoperative day 14 of the second procedure with no complications.

Original languageEnglish
Pages (from-to)e270-e272
JournalThe Journal of craniofacial surgery
Volume30
Issue number3
DOIs
StatePublished - 1 May 2019

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Surgical Flaps
Free Tissue Flaps
Scalp
Wrist
Transplants
Veins
Radial Artery
Skin
Neck Dissection
Splints
Superficial Back Muscles
Common Carotid Artery
Sutures
Arm
Head
Muscles

Cite this

Ku, Inhoe ; Kim, Taewoon ; Choi, Kyujin ; Na, Hyoungmin ; Lee, Janghyuk ; Jeong, Euicheol. / A Large Scalp Defect Coverage With Pedicled Free Flap Using the Wrist as a Free Flap Carrier. In: The Journal of craniofacial surgery. 2019 ; Vol. 30, No. 3. pp. e270-e272.
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abstract = "The absence of an adequate recipient vessel for free flap pedicle anastomosis near local defect sites discourages surgeons from performing free flap transfers over the scalp because of the challenging neck dissection and the thrombogenic potential of vein grafts for pedicle elongation. We present a case in which a large scalp defect was successfully reconstructed using the wrist as a {"}free flap carrier,{"} which is an alternative method. A 78-year-old patient with a totally occluded common carotid artery presented to our clinic with a large scalp defect. Reconstruction of the scalp defect was performed in a 2-stage procedure. In the first stage, a free latissimus dorsi (LD) muscle flap was transferred to the defect site, and the pedicle anastomosis was held at the ipsilateral wrist to provide inflow and outflow of blood through the radial artery and vena comitante and cephalic vein that were anastomosed to the flap pedicle. After subsequent split-thickness skin graft, the elevated position of the arm was achieved using a splint and sutures for 3 weeks. In the second stage, the flap was divided, and an additional skin graft over the flap division site and radial artery repair with vein graft was performed. Successful coverage of the scalp defect was confirmed on postoperative day 14 of the second procedure with no complications.",
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A Large Scalp Defect Coverage With Pedicled Free Flap Using the Wrist as a Free Flap Carrier. / Ku, Inhoe; Kim, Taewoon; Choi, Kyujin; Na, Hyoungmin; Lee, Janghyuk; Jeong, Euicheol.

In: The Journal of craniofacial surgery, Vol. 30, No. 3, 01.05.2019, p. e270-e272.

Research output: Contribution to journalArticleResearchpeer-review

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