Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 3-4, Pages: 219-222
https://doi.org/10.2298/SARH1404219V
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Second look procedure for large burn defect by banana peel pericranial flap based on one artery
Veličkov Asen (Medical Faculty, Niš)
Kovačević Predrag (Medical Faculty, Niš + Clinic of Plastic and Reconstructive Surgery, Clinical Center, Niš)
Petrović Dragan (Medical Faculty, Niš + Clinic of Maxillofacial Surgery, Clinical Center, Niš)
Petrović Slađana (Medical Faculty, Niš + Institute of Radiology, Clinical Center, Niš)
Kovačević Tatjana (Clinic of Plastic and Reconstructive Surgery, Clinical Center, Niš)
Veličkov Aleksandra (Medical Faculty, Niš)
Introduction. Scalp and calvarial defects may result from trauma, thermal or
electrical burns, resection of benign or malignant tumors, infections or
radionecrosis. Reconstruction of large scalp defects is a demanding
procedure. The reconstructive ‘‘ladder’’ are applicable to scalp and
calvarial defects reconstruction. Case Outline. A 68-year-old female was
admitted to our clinic due to the nine-day old scalp burn wound, incurred
under unclear circumstances. Third degree burn wound affected the left
frontal-parietal, temporal and part of the occipital region with
carbonification of the whole left ear lobe. The treatment was carried out in
two stages. Radical full thickness necrectomy of the scalp was performed, the
defect margins were curetted to the active bleeding, and the ear lobe was
amputated. The defect sized 23 x 15 cm was reconstructed using the “banana
peel” transposition galea-cutaneous flap from the remainder of the scalp,
which was based only on the right occipital artery. Two months after the
surgery the appearance was satisfactory, and all wounds were healed.
Conclusion. Designing of large-scale flaps is very hazardous, especially in
elderly people. Scalp reconstruction based on one artery has to be planned in
detail and performed when the possibility of complication is reduced to
minimum. Our case report underlines possible reconstruction as delayed
procedure even with the exposed bone (second look procedure), as well as the
reconstruction of half scalp with the local flap based on one pericranial
artery.
Keywords: scalp defect, delayed reconstruction, third degree burn, occipital artery, pericranial flap
Projekat Ministarstva nauke Republike Srbije, br. III 41018