Application of the pinwheel flap for closure of a large defect of the scalp.

Application of the pinwheel flap for closure of a large defect of the scalp.:

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Application of the pinwheel flap for closure of a large defect of the scalp.

BMJ Case Rep. 2019 Aug 13;12(8):

Authors: Varnalidis I, Mantelakis A, Spiers HVM, Papadopoulou AN

Abstract

A 74-year-old man had a resultant large oval scalp defect of 12×6 cm (72 cm2) following an excision of a stage IIIA melanoma. We decided to cover the defect with the pinwheel flap, with the aim to provide a good cosmetic result, preservation of hair follicles and minimal donor-site morbidity. This local flap has been traditionally used for much smaller defects. Four L-shaped flaps were designed at equal distances on the vertical and horizontal axes of the defect. The L-shaped flap had a length of 1.5 times the half diameter of the defect (4.5 cm). The incision was made through galea aponeurosis and subsequently undermined at least 3 cm to assist flap advancement. Z-plasties increased the rotation of the flap when it was required. This yielded an excellent reconstructive result at 1-year follow-up, demonstrating the usefulness of the pinwheel flap in large defects on the scalp region.

PMID: 31413048 [PubMed - indexed for MEDLINE]