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Yang et al. Plast Aesthet Res 2021;8:54 Plastic and
DOI: 10.20517/2347-9264.2021.40
Aesthetic Research

Original Article Open Access

The role of free tissue transfer in reconstruction of
full thickness scalp defects

2
1
Sara Yang , Megan S. Wu , Amy L. Pittman 1
1
Department of Otolaryngology Head and Neck Surgery, Loyola University Medical Center, Maywood, IL 60153, USA.
2
Department of Otolaryngology Head and Neck Surgery, Loyola University Chicago Stritch School of Medicine, Maywood, IL
60153, USA.
Correspondence to: Assoc. Prof. Amy L. Pittman, Department of Otolaryngology Head and Neck Surgery, Facial Plastics and
Reconstructive Surgery, Microvascular, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA.
E-mail: apittman@lumc.edu

How to cite this article: Yang S, Wu MS, Pittman AL. The role of free tissue transfer in reconstruction of full thickness scalp
defects. Plast Aesthet Res 2021;8:54. https://dx.doi.org/10.20517/2347-9264.2021.40

Received: 25 Apr 2021 First Decision: 2 Jul 2021 Revised: 19 Jul 2021 Accepted: 3 Aug 2021 Published: 15 Aug 2021

Academic Editors: Matthew Spector, Mark K. Wax Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: Describe our institutional experience with different forms of reconstruction, including free tissue transfer vs.
other newer techniques such as Integra, an artificial dermis composed of bovine collagen lattice with a layer of an
artificial synthetic silicon epidermis.

Methods: We performed a retrospective review of patients who underwent full-thickness scalp reconstruction at a
single tertiary care institution between January 2016 and March 2021. Patient demographic information, co-
morbidities, defect depth and size, reconstruction type, American Society of Anesthesiologists (ASA) score, and
postoperative complications were collected.

Results: Of the total 32 patients collected, 68.7% were male and 31.2% were female with an average age of 57.88
years (range 3-91 years). Malignancy (n = 26, 81.2%) was the most common reason for scalp reconstruction,
followed by trauma (n = 5, 12.5%) and non-healing wound/exposed hardware (n = 2, 6.2%). The majority of
patients underwent reconstruction with Integra +/- split thickness skin graft (n = 15, 46.8%) followed by tissue
expander in combination with local flap (n = 6, 18.7%) and microvascular reconstruction (n = 5, 15.6%). Patients
who underwent reconstruction with Integra had more medical comorbidities and a higher ASA score (2.93 ± 0.25)
than those who underwent free tissue transfer (2.75 ± 0.96). Large defects (> 6.1 cm) were mostly reconstructed
via the Integra/Integra + STSG method (n = 13, 59.1%), and all immunosuppressed patients were reconstructed

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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