title: A critical appraisal of the use of free flaps in primary reconstruction of combined scalp and calvarial cancer defects.
abstract: Eleven patients had scalp tumours with full thickness calvarial invasion excised and reconstructed with free flap transfer as a primary procedure. Latissimus dorsi or radial forearm flaps were used, with split rib calvarial reconstruction. One flap was lost peroperatively and another necrosed at 8 days following pedicle compression against an acrylic "skull". Only six patients presently survive, two being treated for recurrence. Long-term follow-up indicates that poor prognostic factors are advanced local invasion, squamous or anaplastic tumours, and advanced age. However, palliative treatment has a role.
authors.affiliation: Plastic and Reconstructive Surgery Centre, St Lawrence Hospital, Chepstow.
authors.forename: M J
authors.initials: MJ
authors.lastname: Earley
authors.forename: M F
authors.initials: MF
authors.lastname: Green
authors.forename: M A
authors.initials: MA
authors.lastname: Milling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012272:Ribs / Q000637:transplantation; D012535:Scalp / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D012886:Skull / Q000473:pathology / Q000601:surgery*; D012888:Skull Neoplasms / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps / Q000379:methods*