Anchoring galeal flaps for scalp reduction procedures

This article describes an operative technique, based on the use of three an choring galeal flaps, aimed at reducing the percentage of "stretch-back" th at occurs after performing scalp reduction procedures. In 12 male patients undergoing a midline scalp reduction procedure, three rectangular (2 x 3 cm ) galeal flaps in direct continuity with the longitudinal margin of the lef t scalp flap were sutured individually to the galeal undersurface of the ri ght scalp flap to draw the two scalp flaps toward the midline of the scalp and to relieve the wound margins of closing tension. Tattoo marks were plac ed on the patient's scalp at the level of the vertical lines drawn through the external auditory meatuses (A1-A2) and 6 cm more posterior (B1-B2) to m easure the movement and stretching of the scalp. The results were compared with those obtained from a control group of 13 male patients who underwent the same surgical procedure but without the use of the anchoring galeal fla ps. Mean stretch-back (as measured 4 weeks postoperatively) at level A1-A2 was 8.3 mm in the control group and 1.6 mm in the experimental group. The m ean stretch-back at level B1-B2 was 7.7 mm in the con control group and 0.9 mm in the experimental group. A statistically significant difference (p < 0.005) was found between data from the control and experimental groups rega rding the above-reported stretch-back values at both levels. The use of the described galeal flaps allowed us to obtain an 80.93-percent and an 88.09- percent stretch-back reduction at levels A1-A2 and B1-B2, respectively, 1 m onth postoperatively.