Microsurgical Reconstruction of Complex Scalp Defects: An Appraisal of XXXX Selection and the Timing of Complications.

@entity1 @entity1912 @entity11885
BACKGROUND: The purposes of this study were to report a 7-year experience of microvascular reconstruction of scalp defects, compare @entity1912 type and outcomes, and evaluate the implications of short and long term complications. METHODS: Following institutional review board approval, a single surgeon's @entity1 requiring microvascular scalp reconstruction were retrospectively reviewed from 2005 to 2011. @entity1912 choice, complications, and outcomes were statistically analyzed. RESULTS: Nineteen @entity1 met inclusion criteria (10 male and 9 female) with a mean age of 60.2  21.4 years (range, 23-90 years). All free tissue transfers (n=20) achieved 100% soft tissue coverage. Mean size calvarial defect was 106.6  67.2cm (range, 35-285cm), with 11 requiring cranioplasty. Free flaps included the following: 13 anteriolateral thigh, 5 ulnar, 1 latissimus dorsi, and 1 thoracodorsal artery perforator. Mean @entity1912 size was 154.1  87.3cm (range, 42-336cm). Early complications (<30 days following surgery) occurred in 21.1% of @entity1 and late complications (>30 days following surgery) in 52.6% of @entity1 . @entity1 with an early complication were 2 times more likely to develop a late complication (relative risk, 2.1) but did not reach statistical significance. Late complications were more likely to require surgical intervention, 84.2% versus 60% of early complications (P=0.079). CONCLUSIONS: Microvascular free tissue transfer is the @entity11885 but carries a high likelihood of future reoperations. Early complications are less concerning than late complications, as the need for future surgical intervention is associated with late complications. There is lack of evidence to support a superior @entity1912 choice.
