Subcutaneous tissue in the scalp: anatomical, physiological, and clinical study.

The galea aponeurotica has been used by various surgeons either as a supporting sheet or as a blood carrier for bringing flaps to various areas of the face. In this study, we first reviewed the anatomy of the scalp vascularization by means of cadaver injections. The arteries and veins are mainly located in the galea and numerous anastomotic vessels are present over the vertex. The physiology of this vascularization has been studied by percutaneous PO2 registration after occlusion of various vessels by means of a tourniquet placed around the head. The superficial temporal arteries have been found to be the most important vessels for designing flaps over the head. On the basis of these experiments, several patients have been operated upon. The possibility of using a skin island from the retroauricular region based on subcutaneous tissue only is described.