Fundamental of Scalp: Anatomy and Reconstruction

The scalp is the anatomical area composed of soft tissue layers that cover the skull. Scalp defects may be partial or full thickness and can be acquired or (less frequently) congenital. Direct edge approximation or local flaps provide hair-bearing skin and are, therefore, the preferred options. However, regional or distant (free) flaps may be necessary for medium-to-large-sized defects. The choice for reconstruction technique depends on multiple factors such as the defect dimensions and depth, the patient characteristics, and the surgeon’s preference.