Ebrahimi Ali, Nejadsarvari Nasrin, Ebrahimi Azin
Department of Plastic Surgery, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Medical Ethics, Iran University of Medical Sciences, Tehran, Iran.
J Cutan Aesthet Surg. 2017 Apr-Jun;10(2):106-108. doi: 10.4103/JCAS.JCAS_138_16.
Defects of the scalp arise from several aetiologies including trauma, burn, injury, infection, radiation and surgical excision of tumours. Multiple options for reconstruction of scalp defects exist that included primary closure, skin grafts, local flaps, regional and distal free flaps.
This was a prospective case-series study, which was carried out in the Department of Plastic Surgery of our Hospital. Step flap was used for small (2.5 cm × 2.5 cm) scalp skin defects reconstructions after skin tumour ablations. In this 2 years study, 15 patients (7 female , 8 male), ranging from 40 to 72 years (mean, 53 years), underwent an operation with local step flap for reconstruction of scalp defects caused by basal cell carcinoma or squamous cell carcinoma excision.
The patients who present with small scalp malignant tumours need complete resection and perfect reconstruction. This study showed that step flap with sufficient releasing was an effective method for reconstruction of small scalp defects due to skin malignancies. We had no case of flap complications such as ischaemia or necrosis.
We recommend this local flap (z-flap) as a new approach for small scalp defect reconstruction in all areas of hair-bearing scalp.
头皮缺损由多种病因引起，包括创伤、烧伤、损伤、感染、放疗以及肿瘤的手术切除。头皮缺损的重建有多种选择，包括一期缝合、皮肤移植、局部皮瓣、区域和远位游离皮瓣。
这是一项前瞻性病例系列研究，在我院整形外科进行。对于皮肤肿瘤切除术后的小面积（2.5厘米×2.5厘米）头皮皮肤缺损，采用阶梯皮瓣进行重建。在这项为期2年的研究中，15例患者（7例女性，8例男性），年龄在40至72岁之间（平均53岁），接受了局部阶梯皮瓣手术，以重建因基底细胞癌或鳞状细胞癌切除导致的头皮缺损。
患有小面积头皮恶性肿瘤的患者需要完整切除并进行完美重建。本研究表明，充分松解的阶梯皮瓣是重建因皮肤恶性肿瘤导致的小面积头皮缺损的有效方法。我们没有出现皮瓣缺血或坏死等并发症病例。
我们推荐这种局部皮瓣（Z形皮瓣）作为重建有毛发头皮所有区域小面积头皮缺损的新方法。
