-
Current Opinion in Otolaryngology &... Oct 2015Scalp reconstruction remains an evolving field. This study will highlight scalp reconstruction methods, and highlight new technologies and surgical techniques. (Review)
Review
PURPOSE OF REVIEW
Scalp reconstruction remains an evolving field. This study will highlight scalp reconstruction methods, and highlight new technologies and surgical techniques.
RECENT FINDINGS
Dermal replacements have become increasingly popular as an adjunctive method to increase skin graft take.External tissue expansion has obviated the need for preoperative skin expansion prior to definitive surgery and may be an attractive option for oncology cases.
SUMMARY
Scalp reconstruction is a complex interplay of patient factors, surgeon experience, and available techniques and technologies. The thoughtful surgeon is wise to tailor reconstruction to provide adequate coverage with the least morbidity. This study highlights interesting developments in scalp reconstruction, which may expand the surgeon's ability to do so.
Topics: Humans; Plastic Surgery Procedures; Scalp; Skin Transplantation; Skin, Artificial; Surgical Flaps
PubMed: 26339972
DOI: 10.1097/MOO.0000000000000191 -
Journal of the American Academy of... Sep 1989Abnormally placed or absent scalp whorls have been associated with abnormal brain development. Defects of bony cranial development are not associated with such patterns.... (Review)
Review
Abnormally placed or absent scalp whorls have been associated with abnormal brain development. Defects of bony cranial development are not associated with such patterns. Single and double parietal whorls are examples of normal scalp patterns. Frontal patterns are variable, and scalp whorls associated with a cowlick can be seen at any location along the frontal hair line. A case of triple parietal scalp whorls and a case of a right temporal scalp whorl, both associated with normal development, are described. Current theories of hair whorl development, as well as normal and abnormal scalp whorl patterns, also are discussed.
Topics: Hair; Humans; Scalp
PubMed: 2674215
DOI: 10.1016/s0190-9622(89)70225-5 -
Facial Plastic Surgery Clinics of North... Feb 2017The scalp presents many challenges to the reconstructive surgeon given its visible nature and the various considerations that must be given for optimal reconstruction.... (Review)
Review
The scalp presents many challenges to the reconstructive surgeon given its visible nature and the various considerations that must be given for optimal reconstruction. In this article, we review the anatomy of the scalp, the various options for reconstruction, and important considerations for improving the chances of optimal reconstruction of scalp defects.
Topics: Cicatrix; Humans; Plastic Surgery Procedures; Scalp; Skin Transplantation; Surgical Flaps; Tissue Expansion
PubMed: 27888896
DOI: 10.1016/j.fsc.2016.08.013 -
Facial Plastic Surgery Clinics of North... May 2005The unique properties of the human scalp affect the surgeon's ability to reconstruct defects in this area. The scalp has a rich vascular supply, the ability to withstand... (Review)
Review
The unique properties of the human scalp affect the surgeon's ability to reconstruct defects in this area. The scalp has a rich vascular supply, the ability to withstand wounds of greater tension than other regions, and often has hair that can camouflage resulting scars or asymmetries. Nevertheless, most of the scalp is relatively inelastic and is ideally reconstructed with hair-bearing skin. These properties compromise the ease of effective reconstruction. However, multiple reconstructive options exist. The selection depends on the size and thickness of the defect, its location on the scalp, limiting comorbidities of the patient, and the need for immediate or delayed reconstruction. These options are reviewed in a systematic manner, organized by the factors outlined previously.
Topics: Humans; Plastic Surgery Procedures; Scalp; Skin Neoplasms; Skin Transplantation; Tissue Expansion
PubMed: 15817412
DOI: 10.1016/j.fsc.2004.12.003 -
Experimental Dermatology Dec 2011Scalp pruritus is a common complaint that is considered a diagnostically and therapeutically challenging situation. Scalp skin has a unique neural structure that... (Review)
Review
Scalp pruritus is a common complaint that is considered a diagnostically and therapeutically challenging situation. Scalp skin has a unique neural structure that contains densely innervated hair follicles and dermal vasculature. In spite of the recent advances in our understanding of itch pathophysiology, scalp itching has not been studied as yet. In this review, we summarize the current knowledge on the neurobiology of scalp and hair follicles as well as itch mediators and provide a putative mechanism for scalp itch with special emphasis on neuroanatomy and pathophysiology.
Topics: Animals; Humans; Pruritus; Scalp; Sebum
PubMed: 22092575
DOI: 10.1111/j.1600-0625.2011.01389.x -
Dermatologic Clinics Jan 2005The article focuses on scalp reconstruction of surgical wounds following skin cancer resection. In contrast to other cosmetic units, scalp wounds are closed under... (Review)
Review
The article focuses on scalp reconstruction of surgical wounds following skin cancer resection. In contrast to other cosmetic units, scalp wounds are closed under significant tension, because the galea restricts overlying tissue movement. For defects that cannot be closed primarily, rotation flaps developed within the subgaleal space are often the best reconstruction option.
Topics: Humans; Plastic Surgery Procedures; Scalp; Surgical Flaps
PubMed: 15620616
DOI: 10.1016/j.det.2004.09.011 -
Current Opinion in Otolaryngology &... Aug 2006The present review summarizes traditional and advanced techniques used to reconstruct defects of the scalp. These deformities range from small defects that can be closed... (Review)
Review
PURPOSE OF REVIEW
The present review summarizes traditional and advanced techniques used to reconstruct defects of the scalp. These deformities range from small defects that can be closed primarily to significant defects, which require free tissue transfer.
RECENT FINDINGS
Increased use of tissue expanders, advancement rotational flaps, and hair transplantation has resulted in improved cosmetic outcomes for larger defects of the scalp. Free tissue transfer has provided a revolutionary method of reconstructing subtotal and total defects of the scalp, in particular those associated with neoplasms.
SUMMARY
New advances in techniques of scalp reconstruction have provided improved outcomes in terms of cosmetic appearance and decreased morbidity for scalp reconstruction.
Topics: Hair; Humans; Plastic Surgery Procedures; Scalp; Skin Transplantation; Surgical Flaps; Tissue Expansion; Transplantation, Homologous; Treatment Outcome
PubMed: 16832181
DOI: 10.1097/01.moo.0000233595.61305.d8 -
Otolaryngologic Clinics of North America Jun 2001This article presents a systematic approach to the reconstruction of scalp defects, which includes a review of the anatomy of the scalp as it pertains to reconstruction,... (Review)
Review
This article presents a systematic approach to the reconstruction of scalp defects, which includes a review of the anatomy of the scalp as it pertains to reconstruction, and a discussion of the various reconstructive options for scalp defects, such as grafts and flaps. Further, scalp flap selection, design, and execution are outlined. Finally, adjunctive techniques of tissue expansion and hair transplants are included to enhance the final aesthetic result.
Topics: Humans; Scalp; Surgical Flaps; Tissue Expansion
PubMed: 11447003
DOI: 10.1016/s0030-6665(05)70006-2 -
Advances in Neonatal Care : Official... Dec 2003Scalp hair growth and patterning are closely associated with the development of the central nervous system. A number of genetic, metabolic, and neurologic disorders are... (Review)
Review
Scalp hair growth and patterning are closely associated with the development of the central nervous system. A number of genetic, metabolic, and neurologic disorders are associated with recognizable scalp hair abnormalities. For this reason, a systematic step-by-step assessment of the hair and scalp should be an integral part of every initial newborn physical assessment. This article reviews the clinically relevant embryology related to fetal scalp hair formation. Normal cycles of hair growth and loss are discussed. A systematic review of typical newborn scalp hair characteristics such as color, quantity, texture, direction of growth, hairlines, and hair whorls is provided. Conditions associated with abnormal hair color, quality, quantity, and distribution are presented in a series of clinical photographs, and their salient features are discussed. Abnormal hair often occurs as a constellation of findings; implications for clinical care and further investigation will be briefly described.
Topics: Hair; Hair Diseases; Humans; Infant, Newborn; Scalp
PubMed: 14695500
DOI: 10.1016/j.adnc.2003.09.005 -
Current Opinion in Otolaryngology &... Apr 2014Reconstruction of scalp defects remains a challenge. This article reviews the reconstructive options and provides recommendations for scalp restoration based on current... (Review)
Review
PURPOSE OF REVIEW
Reconstruction of scalp defects remains a challenge. This article reviews the reconstructive options and provides recommendations for scalp restoration based on current literature.
RECENT FINDINGS
It is difficult to apply the standard reconstructive ladder to scalp defects due to the scalp's unique properties and paucity of adjacent tissue. Because of the frequency of large resections and the limited local tissue options microvascular free tissue transfer is a mainstay in scalp reconstruction and has been shown to be well tolerated and reliable with acceptable cosmetic and functional results. With advances in both surgery and anesthesia, increasing numbers of patients are candidates for free tissue transfer. The latissimus dorsi flap is a fundamental flap in scalp reconstruction. Recently, use of the anterolateral thigh (ALT) flap has risen. The radial forearm (RFF) free flap is also an extremely reliable, thin flap with great pedicle length well suited for the restoration of scalp contouring.
SUMMARY
Microvascular free tissue transfer provides well tolerated, reliable, functional and cosmetically pleasing scalp restoration in a single surgery. The latissimus dorsi flap, ALT flap and RFF are the three most utilized free tissue options.
Topics: Esthetics; Humans; Microsurgery; Plastic Surgery Procedures; Scalp; Skin Transplantation; Surgical Flaps; Tissue Expansion
PubMed: 24504223
DOI: 10.1097/MOO.0000000000000028