Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects
Abstract Objective The reconstruction of large scalp defects poses both functional and cosmetic challenges. While free tissue transfer remains the standard for defects larger than 30 cm2, prolonged anesthesia and postoperative complications remain significant limitations. The purpose of this study i...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1016/j.wjorl.2021.04.006 |
| _version_ | 1811185670246367232 |
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| author | Austin C. Cao Ryan M. Carey Mitali Shah Kevin Chorath Robert M. Brody Steven B. Cannady Jason G. Newman Rabie M. Shanti Karthik Rajasekaran |
| author_facet | Austin C. Cao Ryan M. Carey Mitali Shah Kevin Chorath Robert M. Brody Steven B. Cannady Jason G. Newman Rabie M. Shanti Karthik Rajasekaran |
| author_sort | Austin C. Cao |
| collection | DOAJ |
| description | Abstract Objective The reconstruction of large scalp defects poses both functional and cosmetic challenges. While free tissue transfer remains the standard for defects larger than 30 cm2, prolonged anesthesia and postoperative complications remain significant limitations. The purpose of this study is to evaluate the use of O‐Z flaps for the reconstruction of large scalp defects and to describe the techniques employed. Methods This is a retrospective analysis of ten patients who underwent reconstructive surgery using an O‐Z flap approach for large scalp defects between July 2017 and June 2019. The parameters included in this study were patient demographics, tumor characteristics, and postoperative management, collected for at least a year after surgery. Results In this cohort, the mean age was 76.1 years and 90% were male. All patients were treated for neoplastic skin lesions, with 70% located on the vertex and 30% located on the temporoparietal region. The mean size of defect was 52.0 cm2 (range: 38.6 to 63.8 cm2). The maximum hospital stay was two days, and no patients were readmitted within 30 days of surgery. There were no cases of wound infection or flap necrosis. All patients reported pain control with acetaminophen and ibuprofen. Four patients received adjuvant radiation, and there was no delay to receiving treatment following surgery. Conclusions The O‐Z flap is a reliable alternative for the reconstruction of non‐irradiated scalp defects in the vertex and temporoparietal regions up to 63 cm2. This technique provides advantages for patients, including hairline preservation, shorter hospital stays, and decreased postoperative complications. |
| first_indexed | 2024-04-11T13:33:09Z |
| format | Article |
| id | doaj.art-4f203b5a7d3a44c8aa156af8c2219eb3 |
| institution | Directory Open Access Journal |
| issn | 2095-8811 2589-1081 |
| language | English |
| last_indexed | 2024-04-11T13:33:09Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| spelling | doaj.art-4f203b5a7d3a44c8aa156af8c2219eb32022-12-22T04:21:40ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812022-12-018435536010.1016/j.wjorl.2021.04.006Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defectsAustin C. Cao0Ryan M. Carey1Mitali Shah2Kevin Chorath3Robert M. Brody4Steven B. Cannady5Jason G. Newman6Rabie M. Shanti7Karthik Rajasekaran8Perelman School of Medicine University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADrexel University College of Medicine Drexel University Philadelphia 19102 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PADepartment of Otorhinolaryngology ‐ Head and Neck Surgery University of Pennsylvania Philadelphia 19104 PAAbstract Objective The reconstruction of large scalp defects poses both functional and cosmetic challenges. While free tissue transfer remains the standard for defects larger than 30 cm2, prolonged anesthesia and postoperative complications remain significant limitations. The purpose of this study is to evaluate the use of O‐Z flaps for the reconstruction of large scalp defects and to describe the techniques employed. Methods This is a retrospective analysis of ten patients who underwent reconstructive surgery using an O‐Z flap approach for large scalp defects between July 2017 and June 2019. The parameters included in this study were patient demographics, tumor characteristics, and postoperative management, collected for at least a year after surgery. Results In this cohort, the mean age was 76.1 years and 90% were male. All patients were treated for neoplastic skin lesions, with 70% located on the vertex and 30% located on the temporoparietal region. The mean size of defect was 52.0 cm2 (range: 38.6 to 63.8 cm2). The maximum hospital stay was two days, and no patients were readmitted within 30 days of surgery. There were no cases of wound infection or flap necrosis. All patients reported pain control with acetaminophen and ibuprofen. Four patients received adjuvant radiation, and there was no delay to receiving treatment following surgery. Conclusions The O‐Z flap is a reliable alternative for the reconstruction of non‐irradiated scalp defects in the vertex and temporoparietal regions up to 63 cm2. This technique provides advantages for patients, including hairline preservation, shorter hospital stays, and decreased postoperative complications.https://doi.org/10.1016/j.wjorl.2021.04.006Scalp reconstructionLocal flapsFree flap reconstructionFacial plasticsMicrovascular surgeryHead and neck cancer |
| spellingShingle | Austin C. Cao Ryan M. Carey Mitali Shah Kevin Chorath Robert M. Brody Steven B. Cannady Jason G. Newman Rabie M. Shanti Karthik Rajasekaran Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects World Journal of Otorhinolaryngology-Head and Neck Surgery Scalp reconstruction Local flaps Free flap reconstruction Facial plastics Microvascular surgery Head and neck cancer |
| title | Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| title_full | Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| title_fullStr | Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| title_full_unstemmed | Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| title_short | Use of the O‐Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| title_sort | use of the o z flap as an alternative to free tissue transfer for reconstruction of large scalp defects |
| topic | Scalp reconstruction Local flaps Free flap reconstruction Facial plastics Microvascular surgery Head and neck cancer |
| url | https://doi.org/10.1016/j.wjorl.2021.04.006 |
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