Microsurgical Reconstruction of Oncological Scalp Defects in the Elderly

Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Filip Simunovic, Steffen U. Eisenhardt, Vincenzo Penna, Jan R. Thiele, G. Björn Stark, Holger Bannasch
The incidence of scalp tumors requiring radical excision increases with age. Free-flap surgery is the standard reconstructive option for large defects, however there is ongoing uncertainty about its safety in the elderly. We conducted a review of data and report on 19 cases older than 75 and 13 younger than 75 years. Data regarding patient demographics, types of tumors, surgery, size of defect, flaps used and prevalence of complications were analyzed. The patients in the elderly group had more accompanying medical conditions and a higher ASA Score. Squamous cell carcinoma was the predominant tumor in the elderly, and sarcoma in the younger patients. The defect size was similar in both groups. Most commonly used were the latissimus dorsi (LD) and the anterolateral thigh flap (ALT), with temporal vessels used for anastomosis. Surgery lasted longer in the younger patients. There was no difference in the duration of hospital stay. There was no significant correlation between age and the flap-related or medical complications. Revision surgery was more often required in younger patients. We conclude that free flap surgery is safe and reliable in the elderly population. The most commonly used flaps are the LD and the ALT flap. Advanced age should not be considered a risk factor for free flap surgery in these patients.



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