Rhomboid Flap in Scalp Defect Reconstruction – ROJoson -14Sept1

Problem-based Learning in Surgery

Use of rhomboid flap after a wide excision of skin and soft tissue malignancy in the scalp (occipital area)

denis_ocayo_scalp_rhomboid_14sept1 (1)

denis_ocayo_scalp_rhomboid_14sept1 (2)

denis_ocayo_scalp_rhomboid_14sept1 (3)

Preliminary planning and drawing

denis_ocayo_scalp_rhomboid_14sept1 (4)

Recurrent malignancy, left posterior auricular area

denis_ocayo_scalp_rhomboid_14sept1 (5)

Outline of elliptical incision with margin around the tumor – around 1 cm.

denis_ocayo_scalp_rhomboid_14sept1 (6)

Outline of rhomboid flap

denis_ocayo_scalp_rhomboid_14sept1 (7)

Incision adjusted to a rhomboid with planning of rhomboid flap

denis_ocayo_scalp_rhomboid_14sept1 (8)

Some tentative planning for dog ears.

denis_ocayo_scalp_rhomboid_14sept1 (10)

After wide excision of the malignancy – with resultant scalp defect – about 3.5 cm wide (transverse axis).

denis_ocayo_scalp_rhomboid_14sept1 (12)

Creation of the rhomboid flap

denis_ocayo_scalp_rhomboid_14sept1 (13)

Rhomboid flap rotated to the main scalp defect.

denis_ocayo_scalp_rhomboid_14sept1 (13b)

Temporary guide sutures placed.

denis_ocayo_scalp_rhomboid_14sept1 (14)

Wound repaired and closed with internal sutures with a rubber drain.

denis_ocayo_scalp_rhomboid_14sept1 (18)

Wound repair completed with external sutures.

denis_ocayo_scalp_rhomboid_14sept1 (19)

Specimen view from the surface.

denis_ocayo_scalp_rhomboid_14sept1 (20)

Cut section of the specimen showing the two tumors.

ROJ@14sept1

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