Lauck KC, Rickstrew JJ, Tolkachjov SN. Bilateral Forehead Rotation Flap with Skin Substitute Application for Convexity Replacement.
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024;
12:e5590. [PMID:
38268715 PMCID:
PMC10807875 DOI:
10.1097/gox.0000000000005590]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/27/2023] [Indexed: 01/26/2024]
Abstract
Large forehead defects pose reconstructive challenges, considering the tissue inelasticity and the need to preserve symmetry of the eyebrow and hairline. Local skin flaps and primary closures are mainstays of forehead reconstruction with many techniques reported, but they may not cover the entire defect. Further closure options with acceptable cosmesis are limited. While providing a functional alternative, skin grafting may take on an atrophic concavity and shiny texture. Free flaps similarly may not accurately replicate the contour of the forehead and may be discordant with the texture of adjacent skin. We describe a reproducible technique for closing a large central forehead defect in a single-stage local flap while retaining symmetry of eyebrows and neurovascular integrity. We also propose serially applying a skin substitute to the remaining portion of the defect to recreate forehead convexity and potentially expedite healing. This technique may represent a viable and reproducible method for recreating the natural contour of the forehead when complete closure may not be an option.
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