title: Reconstruction of scalp defects with exposed bone after surgical treatment of basal cell carcinoma: the use of a bilayer matrix wound dressing.
abstract: Treatment of scalp defects after tumor resection or traumatic events is a challenging problem. Large defects with loss of soft tissue down to the bone require complex reconstructive options, including tissue expansion, local and distal scalp flaps, and free split thickness skin graft. Nonetheless, these techniques are often disfiguring and are limited by the relatively poor elasticity and vascularity of scalp tissues after recurrent resection or previous irradiation. Moreover, comorbid conditions among elderly patients often limit anesthetic tolerance and the use of distant flaps. We report a case of a 75-year-old woman with large tissue loss and bone exposure after Mohs micrographic surgery of basal cell carcinoma of the scalp which was successfully rebuilt through the use of a skin substitute. We describe the uncommon use of a bilayer matrix wound dressing as a single procedure option for the management of full-thickness scalp defects with bone exposure.
authors.affiliation: Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Gironi
authors.affiliation: Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boggio
authors.affiliation: Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Colombo
mesh_terms: D000368:Aged; D001684:Biological Dressings; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015580:Mohs Surgery / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D016896:Treatment Outcome; D014945:Wound Healing
keywords: full-thickness; scalp defects; skin substitute