Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps
Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic pat...
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doaj-2c0df367757641f59af6c52c9d6c564a2021-09-09T13:49:29ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103863386310.3390/jcm10173863Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free FlapsJosé Luis del Castillo Pardo de Vera0Carlos Navarro Cuéllar1Ignacio Navarro Cuéllar2José Luis Cebrián Carretero3Sandra Bacián Martínez4María Isabel García-Hidalgo Alonso5Arturo Sánchez-Pérez6Jose J. Zamorano-León7Antonio J. López-Farré8Carlos Navarro Vila9Maxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, SpainMaxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, SpainMaxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, SpainMaxillofacial Surgery Department, Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, SpainMaxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, SpainRadiology Department, Hospital Puerta de Hierro, 28046 Madrid, SpainFaculty of Medicine, Murcia University, 30100 Murcia, SpainFaculty of Medicine, Universidad Complutense de Madrid, 28046 Madrid, SpainFaculty of Medicine, Universidad Complutense de Madrid, 28046 Madrid, SpainMaxillofacial Surgery Department, General Universitario HLA Moncloa, Avenida de Valladolid, 83, 28008 Madrid, SpainMicrosurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (<i>p</i> < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (<i>p</i> < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (<i>p</i> < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (<i>p</i> = 0.002). The mean hospital stay after surgery was not statistically significant (<i>p</i> > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (<i>p</i> = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects.https://www.mdpi.com/2077-0383/10/17/3863scalp reconstructionanterolateral thigh flapomental flaplatissimus dorsi flap |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
José Luis del Castillo Pardo de Vera Carlos Navarro Cuéllar Ignacio Navarro Cuéllar José Luis Cebrián Carretero Sandra Bacián Martínez María Isabel García-Hidalgo Alonso Arturo Sánchez-Pérez Jose J. Zamorano-León Antonio J. López-Farré Carlos Navarro Vila |
spellingShingle |
José Luis del Castillo Pardo de Vera Carlos Navarro Cuéllar Ignacio Navarro Cuéllar José Luis Cebrián Carretero Sandra Bacián Martínez María Isabel García-Hidalgo Alonso Arturo Sánchez-Pérez Jose J. Zamorano-León Antonio J. López-Farré Carlos Navarro Vila Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps Journal of Clinical Medicine scalp reconstruction anterolateral thigh flap omental flap latissimus dorsi flap |
author_facet |
José Luis del Castillo Pardo de Vera Carlos Navarro Cuéllar Ignacio Navarro Cuéllar José Luis Cebrián Carretero Sandra Bacián Martínez María Isabel García-Hidalgo Alonso Arturo Sánchez-Pérez Jose J. Zamorano-León Antonio J. López-Farré Carlos Navarro Vila |
author_sort |
José Luis del Castillo Pardo de Vera |
title |
Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps |
title_short |
Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps |
title_full |
Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps |
title_fullStr |
Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps |
title_full_unstemmed |
Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps |
title_sort |
clinical and surgical outcomes in extensive scalp reconstruction after oncologic resection: a comparison of anterolateral thigh, latissimus dorsi and omental free flaps |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (<i>p</i> < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (<i>p</i> < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (<i>p</i> < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (<i>p</i> = 0.002). The mean hospital stay after surgery was not statistically significant (<i>p</i> > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (<i>p</i> = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects. |
topic |
scalp reconstruction anterolateral thigh flap omental flap latissimus dorsi flap |
url |
https://www.mdpi.com/2077-0383/10/17/3863 |
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