Akademik Veri Yönetim Sistemi
Plastic and Reconstructive Surgery, cilt.115, sa.5, ss.1366-1371, 2005 (SCI-Expanded)
The options for vascularized island flaps are very limited because of the anatomy of the scalp. The vascularized island scalp-flaps have been preferred for repair of small facial defects such as eyebrow, mustache, beard, and sideburn. They have generally not been used for reconstruction of the scalp. However, the temporoparietal region has unique anatomical features in the scalp to enable preparation of island vascularized flaps, which can include hairy skin with a large arc of rotation for scalp reconstruction. We performed an anatomical study to investigate the relationship among the superficial temporal artery and layers of the scalp and potential vascularized flap designs. It was observed that the superficial temporal vessels run within the temporoparietal fascia up to 106.21 mm (range, 96 to 131 mm; SD, 8.37 mm) above the zygomatic arch and mark the cephalic border of the temporoparietal fascia. Hairy skin of the scalp beyond the temporoparietal fascia can be raised based on the superficial temporal vessels as an island flap. If there is a limited size scalp defect (<6 cm) and the most inferior point of the defect is at the same level with the cephalic border of the temporoparietal fascia, a vascularized flap can be designed as a V-Y flap and the donor site can be closed primarily. If there is a large scalp defect (>10 cm), hairy skin can be elevated over the pericranium as an island vascularized flap and the donor site can be closed with a graft. This flap has several advantages over the skin pedicle scalp flaps, such as less donor-site morbidity, easier transfer, and a longer arc of rotation.