Evidence map›Paper›PMID 39878191›Full record

ArticleMicrosurgery2025

Microsurgical Reconstruction of Complex Scalp Defects With Vastus Lateralis Free Flap.

Giovanni Zabbia, Emanuele Cammarata, Mara Franza, Francesca Toia, Greta Tondini, Francesca Graziano, Domenico Gerardo Iacopino, Adriana Cordova

Abstract read
In one paragraph

Article in Microsurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Giovanni ZabbiaPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0003-0319-0906
Emanuele CammarataPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0002-6563-7390
Mara FranzaPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0002-5799-1461
Francesca ToiaPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0003-4903-815X
Greta TondiniPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0009-0009-2870-7888
Francesca GrazianoNeurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, Catania, Italy.
Domenico Gerardo IacopinoNeurosurgical Clinic AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0003-1685-5209
Adriana CordovaPlastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0002-5137-4294

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScalp reconstruction is a challenging field for plastic surgeons. In case of large or complex defects, microsurgical-free flaps are usually required. Reconstructive failure can result in high morbidity and in some cases be life-threatening. In this article, we present our experience in the reconstruction of complex scalp defects with the use of a vastus lateralis (VL) free flap. PATIENTS AND

methodsFrom July 2013 to July 2023, we retrospectively analyzed patients who underwent soft tissue reconstruction of the scalp with a VL-free flap at the authors' institution. The patient's demographic, clinical and surgical characteristics, and postoperative complications were recorded and analyzed.

resultsThirty patients were included. The mean age was 67.3 years. Seventeen patients were male, while 13 were female. In 56.7% of patients, defects resulted from cancer resection. In four patients, the defect was limited to the soft tissues while a multi-layer defect with bone and/or dura involvement was present in 26 patients. Soft tissue reconstruction was always achieved with a VL-free flap (n = 30). In 28 cases, a skin-grafted muscular flap was used. The most used recipient vessels were the superior thyroid vessels (n = 18). Complications occurred in six patients (20%): two cases of total flap loss and two cases of infection of the cranioplasty materials requiring their removal. In two cases patients died within 48 h. All patients were satisfied with the aesthetic and functional results at 6 months.

conclusionsIn the case of complex scalp defects, the gold standard is reconstruction through microsurgical flaps that provide well-vascularized tissue and allow to cover large defects, reducing the incidence of infections and ensuring good brain protection even without cranioplasty. In our experience, VL-free flap represents a valid option, providing a low donor site morbidity, the possibility of a two-team approach, and a low complication rate.

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsMicrosurgeryPlastic Surgery ProceduresQuadriceps MuscleScalpSkin NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective Studiesmicrosurgical reconstructionscalp reconstructionsoft tissue reconstructionvastus lateralis free flap

Identifiers

PMID39878191
PMCPMC11776040

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.