title: [CLINICAL APPLICATION OF FREE FLAP ON REPAIR OF SCALP DEFECT AFTER RESECTION OF MALIGNANT TUMOR IN 18 CASES].
abstract: OBJECTIVE
  To investigate the effectiveness of different free flaps in the repair of large defects after resection of scalp malignant tumors.
  
  
  METHODS
  Between March 2012 and January 2015, 18 patients with large defect after resection of scalp malignant tumors were treated with different free flaps. There were 13 males and 5 females with an average age of 49 years (range, 18-72 years). There were 17 cases of squamous carcinoma and 1 case of dermatofibril sarcoma protuberans. The defect size ranged from 15 cm x 12 cm to 22 cm x 17 cm after resection of tumors. Defects were repaired with anterolateral thigh flap in 5 cases, latissimus dorsi myocutaneous flap in 6 cases, thoracodorsal artery perforator flap in 3 cases, and latissimus dorsi muscle flap plus intermediate split thickness skin graft in 4 cases. The flap size was 17 cm x 14 cm to 24 cm x 19 cm. The donor sites of the skin flap were covered with skin graft, while the donor sites of the muscle flap were directly sutured.
  
  
  RESULTS
  Of 14 skin flaps, the other 13 flaps survived except 1 flap necrosis; all muscle flaps survived. The patients were followed up 5-33 months (mean, 20 months). Three patients died because of intracranial metastasis at 5, 7, and 13 months after operation, respectively. Two patients had local recurrence and underwent secondary operation. The results of both appearance and function were satisfactory; secondary operation of thinning the flaps was performed in 4 cases of bulky flaps. The flaps had good wear resistance, without ulceration during follow-up. No obvious impairment was observed after harvesting latissimus dorsi myocutaneous flap.
  
  
  CONCLUSIONS
  Large scalp defects after malignant tumor resection can be effectively repaired by proper application of different free flaps.
authors.forename: Haitao
authors.initials: H
authors.lastname: Xiao
authors.forename: Huaisheng
authors.initials: H
authors.lastname: Wang
authors.forename: Xiaoxue
authors.initials: X
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Cen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult