Resection and Reconstruction of Scalp Metastases: A Literature Review

Background Scalp metastases from malignant tumors are relatively rare and indicate disease progression as well as a poor prognosis. Malignant scalp metastases significantly impair patients' quality of life and lead to poor healing outcomes. Surgical resection is often followed by a wound reconstruction. Review Metastatic lesions are most frequently located in the frontal and parietal regions, followed by the temporal and occipital regions. The scalp consists of five anatomical layers, and the depth of resection should be determined based on the extent of tumor invasion. After tumor resection with confirmed negative margins, wound closure strategies must be considered, including secondary healing, primary direct closure, full-thickness skin grafting, split-thickness skin grafting, local flaps or free flaps reconstruction. Clinical Considerations The choice of surgical approach for scalp reconstruction should be based on the size of the scalp defect and the involvement of underlying bone. Various individual factors (such as scalp laxity, prior surgical history, or defect location) influence the choice of the reconstructive method. The primary goal of any reconstruction procedure is to ensure adequate coverage of the exposed outer cortex of the cranium. Conclusion Surgical modalities such as secondary healing, primary direct closure, full-thickness skin grafting, split-thickness skin grafting, local flaps, or free flaps can effectively address therapeutic and aesthetic requirements when appropriately applied to suitable wounds.