Bucket-Handle Bipedicled Scalp Flaps for Coverage of Cranial Constructs in Cranioplasty

Composite frontal scalp defects involving the frontal bone and full thickness scalp can pose a reconstructive challenge. Often, they necessitate the use of microsurgical free tissue transfer, which can be physiologically demanding in high-risk patients with multiple comorbidities, with exposure to prolonged general anesthesia time and increased surgical morbidity. The experience of a single surgeon was reviewed with reconstruction of composite frontal scalp wounds in 4 patients with structural framework and a bipedicled scalp advancement (ie, "bucket handle") flap, thus obviating the need for free tissue transfer. All 4 patients demonstrated complete wound healing by final follow-up, without need for further reoperations or ulcer recurrence. In face of composite frontal scalp defects in less than ideal candidates for lengthy microsurgical flap procedures, the bucket-handle flap can provide a simple and reliable reconstructive option. Address correspondence and reprint requests to Christopher J. Salgado, MD, Professor of Surgery and Interim Chairman, Division of Plastic Surgery, Section Chief, University of Miami Hospital, University of Miami-Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, 4th Floor, Miami, FL 33136; E-mail: csalgado2@med.miami.edu Received 2 February, 2018 Accepted 6 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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