Scalp Free Flap Reconstruction Using Anterolateral

Abstract

We experienced satisfactory outcomes by synchronously transplanting an artery and veinusing an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel ofa flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due toa fall injury. In this patient, the right temporal cranium was missing and the patient had 4×3cm and 6×5 cm scalp defects. We planned a scalp reconstruction using a latissimus dorsifree flap. Intraoperatively, there was a severe injury to the right superficial temporal vesselbecause of previous neurosurgical operations. A 15 cm long pedicle defect was needed toreach the recipient facial vessels. For the vascular graft, the descending branch of the lateralcircumflex femoral artery and two venae comitantes were harvested.The flap survived well and the skin graft was successful with no notable complications. Whenan interposition graft is needed in the reconstruction of the head and neck region for whichmobility is mandatory to a greater extent, a sufficient length of graft from an anterolateralflap pedicle could easily be harvested. Thus, this could contribute to not only resolving thedisadvantages of a venous graft but also to successfully performing a vascular anastomosis.

Keywords

• Scalp
• Free tissue flaps
• Vascular grafting