title: Long-term superiority of composite versus muscle-only free flaps for skull coverage.
abstract: Long-term follow-up of free flaps used for skull coverage in this experience has revealed that serious sequela are more likely after muscle-only free flaps. Over the past 2 decades, 8 muscle and 6 composite free flaps have been used in 12 patients. Debulking was the only secondary procedure necessary in 1 composite flap. However, implant extrusion through 1 muscle flap and chronic ulcerations after minor trauma in 2 other muscle flaps could be directly attributed to the thinness of these flaps. Whether these problems were a consequence of inevitable muscle atrophy or improper selection of too thin a muscle flap from the outset is unknown. Thus, it must be suggested that either a composite flap or a known thick muscle should be chosen initially if a permanent trouble-free outcome is to be expected.
authors.affiliation: Division of Plastic Surgery, The Lehigh Valley Hospital, Allentown, PA, USA. pbhallock@cs.com
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Hallock
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*