title: Scalp reconstruction with superficial temporal artery island flap: clinical experience on 30 consecutive cases.
abstract: BACKGROUND
  Different techniques are available to reconstruct scalp defects; however, when the cranium is exposed or the hairline compromised, the procedure may become quite challenging. The use of superficial temporal artery fascio-cutaneous flaps has been described mainly to restore the hair-bearing surface of the upper lip or the eyebrow but only few applications in the scalp have been reported. The authors present their experience with the use of superficial temporal artery island flaps to obtain durable coverage and excellent contour in anterior scalp reconstruction.
  
  
  METHODS
  Thirty consecutive defects in the anterior scalp subunits (temporal = 14; parietal = 12; forehead = 4) were reconstructed with ipsilateral V-Y island flaps nourished by frontal and parietal branches of the superficial temporal artery. All defects resulted from skin cancer excision. Twenty-six flaps were based on the parietal branch. The frontal branch pedicle was used in only four cases to resurface defects in the forehead subunit. Glabrous skin flaps were harvested in six patients. Including a venous branch in the pedicle was not mandatory because the venous drainage of the flaps was provided by the perivascular fascial network. For this reason, a fascial pedicle around the artery, 2-3 cm in width, was maintained to minimise flap venous insufficiency.
  
  
  RESULTS
  Twenty-nine flaps healed uneventfully (96.7% flap survival rate), providing stable coverage with a mean follow-up of 12 months. In the early postoperative time (up to 48 h), slight venous stasis was observed in 14 flaps (46.6%), but it resolved spontaneously within 1 week. Two flaps showed severe venous stasis, but in only one case (3.3%) it progressed to distal necrosis requiring surgical revision. No cases of alopecia or hairline distortion were postoperatively registered.
  
  
  CONCLUSIONS
  The use of superficial temporal artery island flaps, mobilised in a V-Y fashion, proved to be an elegant and reliable solution to resurface defects in the anterior scalp subunits in both hairy and bald patients.
authors: Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy.
authors: Stefania
authors: S
authors: Tenna
authors: Beniamino
authors: B
authors: Brunetti
authors: Achille
authors: A
authors: Aveta
authors: Igor
authors: I
authors: Poccia
authors: Paolo
authors: P
authors: Persichetti
mesh_terms: D000368:Aged; D005260:Female; D005546:Forehead / Q000601:surgery; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012535:Scalp / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013699:Temporal Arteries / Q000601:surgery*