Exposed calvarium represents an interesting challenge in reconstructing scalp defects. In order to lay on a skin graft, tissue such as a temporalis flap needs to be mobilized to give a base for the graft to survive on. Otherwise, large “pinwheel” type flaps can be constructed to close this primarily with good success.
This defect was closed with a double layer temporalis muscle flap underlying an occipitally based scalp advancement flap.
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