Lessons Learned in Scalp Reconstruction and Tailoring Free Tissue Transfer in the Elderly: A Case Series and Literature Review

Craniomaxillofacial Trauma and Reconstruction

Michael Sosin³  Branko Bojovic³  Paul N. Manson¹  Eduardo D. Rodriguez²  Carla De La Cruz³  Arif Chaudhry³ 

[1] Department of Plastic Surgery, Johns Hopkins Hospital, Baltimore, Maryland;Department of Plastic Surgery, New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York;Division of Plastic, Reconstructive, and Maxillofacial Surgery, R. Adams Cowley Shock Trauma Center, Baltimore, Maryland

关键词: scalp reconstruction;    cranioplasty;    elderly;    aged;    free flap;   

DOI  :  10.1055/s-0034-1393725

学科分类：口腔科学

来源: Thieme Medical Publishers, Inc.

【 摘 要 】

This article aims to demonstrate an individualized approach to an elderly patient requiring scalp reconstruction, to describe the methodology in flap selection, lessons learned, and report outcomes. A retrospective review of a single surgeon's experience of scalp reconstruction (E. D. R.) using free tissue transfer from 2005 to 2011, in patients older than 70 years, was completed. A total of eight patients met the inclusion criteria, five males and three females, with a mean age of 80.4 years (range, 73–92). Free tissue transfer achieved 100% soft tissue coverage. Six of the eight patients required cranioplasty. The mean size calvarial defect was 92 cm2 (range, 35–285 cm2). The mean flap size was 117.6 cm2 (range, 42–285 cm2). Free flaps included three ulnar, three anterolateral thigh, one latissimus dorsi, and one thoracodorsal perforator flap. The mean follow-up time was 18.4 months (range, 3–46 months). Donor site morbidity was minimal. Mortality was 0%. Immediate flap failure was 0%. Other complications occurred in six of the eight patients. Mean revisionary procedures were 1.25 procedures per patient. It was concluded that chronological age does not increase mortality or catastrophic flap complications; however, morbidity is increased in the elderly and revisionary surgery is likely.

【 授权许可】

Unknown