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)

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Preliminary planning and drawing

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Recurrent malignancy, left posterior auricular area

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

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Outline of rhomboid flap

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Incision adjusted to a rhomboid with planning of rhomboid flap

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Some tentative planning for dog ears.

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

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Creation of the rhomboid flap

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Rhomboid flap rotated to the main scalp defect.

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Temporary guide sutures placed.

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

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Wound repair completed with external sutures.

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Specimen view from the surface.

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Cut section of the specimen showing the two tumors.


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