An algorithm for oncologic scalp reconstruction.
BACKGROUND
Modern reconstructive surgery allows for radical resection and reconstruction of any scalp tumor. However, a significant number of patients are still not treated optimally because of incomplete reconstructive guidelines.


METHODS
The treatment of scalp tumors was documented in 60 patients over a 10-year period. Data regarding tumor type, size, and localization; reconstructive procedure; oncologic, functional, and aesthetic outcome; and complications were collected and analyzed retrospectively. These data were correlated to recurrence and survival rates. The findings extracted from the data were amalgamated to produce the proposed reconstructive algorithm.


RESULTS
Five reconstructive categories were defined and their application could be described in an algorithmic approach. Indications, limitations, and adequate reconstructive procedures for each category were identified. The most important decisions are when to use local flaps versus primary closure and when to use free tissue transfer.


CONCLUSIONS
Radical surgical resection and reconstruction presents the best available method to cure scalp tumors or to establish local disease control in palliative settings. The authors present an algorithm to assist in the planning process of oncologic scalp reconstruction. If this algorithm is applied, the occurrence of inadequate resections and the need for repeated procedures can be minimized.
Iblher
Niklas
N
Freiburg, Germany From the Department of Plastic and Hand Surgery, University of Freiburg Medical Center.
Ziegler
Matthias C
MC
Penna
Vincenzo
V
Eisenhardt
Steffen U
SU
Stark
G Björn
GB
Bannasch
Holger
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012535:Scalp; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult