Open AccessClosure of Scalp Defects Using External Tissue Expander
Author(s) -
O’Reilly Ashley,
Youse Jeremy,
Roenigk Randall,
Price Daniel L.,
Schmitt William R.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a8
Subject(s) - scalp , medicine , tissue expansion , surgery , wound closure , skin grafting , wound healing , malignancy , closure (psychology) , reduction (mathematics) , rotation flap , geometry , mathematics , economics , market economy
Objective 1) Present a novel method of closure of large scalp defects with an external tissue expansion device. 2) Review methods of scalp closure. Method Patients with large central scalp defects secondary to cutaneous malignancy underwent wound closure with a novel external tissue expansion device. The device applies a constant, measured tension to approximate the wound edges. Data regarding patient clinical factors, defect size, and photographs were collected prospectively. Results Four patients had large scalp defects secondary to extirpation of cutaneous malignancies. Two patients with wounds 7.5‐ x 7.5‐cm and 9.5‐ x 5‐cm respectively achieved primary closure after 8 days of expansion. One patient with a 6.5‐ x 7.5‐cm wound had reduction of wound size to 3.5‐ x 2.5‐cm after 14 days. The wound then healed by secondary intention. One patient with a 6‐ x 7‐cm wound achieved closure with the use of bilateral rotation‐advancement flaps after 8 days. This flap ultimately failed and will require free flap reconstruction. There were no other postoperative complications, wound breakdown, or device failures. Conclusion External tissue expansion is a safe and alternative technique to close large scalp defects that would otherwise require skin grafting or free flap reconstruction in appropriately selected patients, and can be achieved in a relatively short period of time.