尽管游离皮瓣手术的进步已经允许重建各种复杂的头皮缺损，但更简单的局部选择继续发挥作用。我们描述了如何使用双蒂或“桶柄”头皮瓣与供体部位的皮肤移植来修复最大 15 厘米 x 20 厘米的大头皮缺损。这个由 11 名患者组成的回顾性病例系列描述了通过问卷收集的皮瓣结果、术后并发症、病理学和患者相关结果。缺陷尺寸范围为 56 cm2 至 220 cm2。所有 11 个皮瓣均存活，没有再次入院或返回手术室。有两次轻微的术后感染。需要重建的病理包括累及骨的侵袭性鳞状细胞癌（45%）、脑血管事件后的颅骨坏死（27%）、创伤（9%）或脑恶性肿瘤（9%）。四名患者（36%）同时接受颅骨成形板颅骨重建。平均而言，因其他原因不需要住院的患者两天后即可出院。所有患者均报告术后功能主观改善，并对手术感到满意。这项研究表明，将皮肤移植到供体部位的大型双蒂头皮瓣是可靠的，具有积极的患者相关结果，并且术后并发症很少。该技术非常适合重建插入颅骨成形板后产生​​的长椭圆形头皮缺损。该手术为不适合游离组织移植的患者以及可能受益于局部皮瓣手术时间短和恢复快的患者提供了一种强有力的替代方案。© 2024 由 Elsevier Ltd 代表英国整形重建协会出版和美容外科医生。

Although advances in free flap surgery have allowed the reconstruction of a wide range of complex scalp defects, simpler local options continue to play a role. We describe how bipedicled or 'bucket handle' scalp flap with skin grafting of the donor site can be used to resurface large scalp defects of up to 15 cm x 20 cm. This retrospective case series of 11 patients describes flap outcomes, post-operative complications, pathology and patient-related outcomes collected via a questionnaire. Defect sizes ranged from 56 cm2 to 220 cm2. All 11 flaps survived with no readmissions or return to theatre. There were two minor post-operative infections. Pathologies requiring reconstruction were invasive squamous cell carcinoma involving the bone (45%), cranial bone necrosis after a cerebrovascular event (27%), trauma (9%) or cerebral malignancy (9%). Four patients (36%) underwent simultaneous cranial reconstruction with a cranioplasty plate. On an average, the patients who did not need to remain in the hospital for other reasons were discharged after two days. All patients reported subjective improvements in function post-operatively and that they were satisfied with the procedure. This study suggests that large bipedicled scalp flaps with skin graft to the donor site are reliable, with positive patient-related outcomes and few post-operative complications. This technique is well suited for reconstructing long elliptical scalp defects created after the insertion of a cranioplasty plate. This procedure provides a robust alternative to patients who are unsuitable for free tissue transfer and those who may benefit from the short operative time and quick recovery time associated with a local flap.© 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.