Rotation flaps in severe tissue losses of the head: Case report

The AA present a case of scalp reconstruction by using a single monopedicled scalp flap based on a single occipital artery in which delay was not used. The patient had undergone secondary surgery for recurrence of a meningioma. The patient's poor conditions contraindicated the use of a microsurgical free flap and septic contamination of the scalp ulcer made skin expansion unadvisable. Pregress surgical procedures were revealed by the presence of a number of scalp scars. The good outcome of the procedure brought about discussion about the role of galea as an axial vascular carrier and about the opportunity of prior surgical delay. In particular, the AA stress the need, on one side, to spare the axial vascular supply and the possibility, on the other, to cut the galea while raising the flap. With the help of transillumination and thanks to a little surgical trick, the AA managed to obtain a sort of intraoperative delay and achieved correction of the defect with a large flap in a single surgical session.