Reconstruction of scalp defect after Moyamoya disease surgery using an occipital pedicle V-Y advancement flap.
Scalp necrosis is an infrequent complication of Moyamoya disease surgery, which is more prevalent in the parietotemporal area. Because scalp vascularity is severely compromised after Moyamoya disease surgery, reconstruction of defects with local scalp tissue is challenging. To cover defects, a flap is needed that is highly vascularized and has great mobility and territory to avoid existing scars. After tracing ipsilateral occipital artery, an advancement flap that was based on occipital artery and vein was designed to fit the defect. The flap was elevated in the subperiosteal layer and advanced without tension to cover the defect. Occipital pedicle V-Y advancement flaps were used in 7 patients who had scalp necrosis of the parietotemporal area and a mean defect size of 8.7 cm. There were no complications such as flap necrosis, infection, or recurrence of defect in all patients during 9-month follow-up. Occipital pedicle V-Y advancement flap is a useful alternative flap for scalp defects after surgical treatments that compromise scalp vascularity, such as Moyamoya disease surgery.
Kwon
Ho
H
Department of Plastic Surgery, Uijongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, Uijongbu, Korea.
Kim
Hyung-Jun
HJ
Yim
Young-Min
YM
Jung
Sung-No
SN
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods*; D002648:Child; D004388:Dura Mater / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D009072:Moyamoya Disease / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000098:blood supply / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013699:Temporal Arteries / Q000601:surgery; D016896:Treatment Outcome