Microsurgical reconstruction of composite scalp and calvarial defects in patients with cancer: A 10‐year experience

BACKGROUND: In scalp reconstruction, soft tissue and osseous defects frequently coexist. The purpose of this study was to compare outcomes of simultaneous scalp and calvarial reconstruction to scalp only reconstruction. METHODS: A review of microsurgical scalp reconstruction with or without cranioplasty over a 10-year period was performed. RESULTS: One hundred thirty-eight scalp reconstructions were performed, of which 48 involved concurrent cranioplasty. The overall rate of perioperative complications was 21.0%, whereas the rate of late recipient site complications was 11.6%. No significant differences in perioperative (p = .56) or late (p = .42) recipient site complications were observed between patients undergoing scalp and calvarial versus scalp only reconstruction. In terms of complications, muscle free flaps with skin grafts were as reliable as free flaps with skin paddles (p = .36). CONCLUSION: Simultaneous scalp and calvarial reconstruction is associated with success rates equivalent to scalp only reconstruction. Muscle flaps covered with skin grafts and flaps with a skin paddle seem to be equally reliable.