RECONSTRUCTION OF EXTENSIVE SCALP DEFECTS WITH RECTUS FREE FLAPS

This review represents the largest reported series involving reconstru ction of complex scalp and calvarial defects with rectus abdominis fre e flaps. Sixteen patients presented with extensive (up to 300 cm(2)) s calp and calvarial defects requiring free tissue transfer for closure. All of the 11 patients who underwent a rectus abdominis free flap had a technically successful microvascular transfer. The defects encounte red involved a wide spectrum of complexities including extensive multi laminar defects with exposed brain and dura, irradiated fields, and in fection. In our institutions, the rectus abdominis muscle has evolved as a uniquely superior donor choice for restoring extensive scalp defe cts for several reasons: (1) accessibility, which eliminates intraoper ative patient repositioning and allows for a simultaneous two-team app roach; (2) minimal donor-site morbidity; (3) vascular reliability; and (4) the ability to supply abundant, easily contoured tissue.