Reconstruction of Scalp Defects: A 10-year Experience

Background: Scalp defects, whether from trauma, burns, or congenital causes, present significant challenges for reconstructive surgery due to the inelasticity of the scalp tissue, complicating both functional and aesthetic restoration. Objective: This study aims to evaluate various methods of scalp defect reconstruction over a 10-year period at Rajshahi Medical College Hospital, Bangladesh, with a focus on patient demographics, defect characteristics, and surgical outcomes. Methods: A retrospective review of patients undergoing scalp reconstruction between 2013 and 2023 was conducted. Data on patient age, gender, etiology, defect location, size, depth, bone exposure, and reconstructive techniques used were analyzed. Various reconstructive methods such as local flaps, skin grafts, and tissue expanders were employed based on the defect characteristics. Surgical outcomes, including complications, healing rates, and aesthetic results, were evaluated over a follow-up period of 6 months to 2 years. Results: A total of 150 patients (120 male, 30 female) were included. The majority (80%) of defects were caused by trauma, followed by burns (15%) and congenital anomalies (5%). Local flaps were the most common reconstructive technique (65%), followed by skin grafts (25%) and tissue expansion (10%). Success rates for wound healing were 90%, with a complication rate of 10%, including infections and partial graft failure. Aesthetic outcomes were rated as good or excellent in 85% of patients, while 10% had moderate results, and 5% had poor cosmetic outcomes. Conclusion: Scalp reconstruction using local flaps offers the highest success rates and aesthetic outcomes. Early intervention and careful selection of techniques based on defect characteristics are critical for optimal results.