{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:36:50Z","timestamp":1784255810683,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scalp reconstruction is a challenging field for plastic surgeons. In case of large or complex defects, microsurgical\u2010free flaps are usually required. Reconstructive failure can result in high morbidity and in some cases be life\u2010threatening.<\/jats:p>\n                    <jats:p>In this article, we present our experience in the reconstruction of complex scalp defects with the use of a vastus lateralis (VL) free flap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>From July 2013 to July 2023, we retrospectively analyzed patients who underwent soft tissue reconstruction of the scalp with a VL\u2010free flap at the authors' institution. The patient's demographic, clinical and surgical characteristics, and postoperative complications were recorded and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty patients were included. The mean age was 67.3\u2009years. Seventeen patients were male, while 13 were female. In 56.7% of patients, defects resulted from cancer resection. In four patients, the defect was limited to the soft tissues while a multi\u2010layer defect with bone and\/or dura involvement was present in 26 patients. Soft tissue reconstruction was always achieved with a VL\u2010free flap (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930). In 28 cases, a skin\u2010grafted muscular flap was used. The most used recipient vessels were the superior thyroid vessels (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918). Complications occurred in six patients (20%): two cases of total flap loss and two cases of infection of the cranioplasty materials requiring their removal. In two cases patients died within 48\u2009h. All patients were satisfied with the aesthetic and functional results at 6\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the case of complex scalp defects, the gold standard is reconstruction through microsurgical flaps that provide well\u2010vascularized tissue and allow to cover large defects, reducing the incidence of infections and ensuring good brain protection even without cranioplasty. In our experience, VL\u2010free flap represents a valid option, providing a low donor site morbidity, the possibility of a two\u2010team approach, and a low complication rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70025","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T06:56:22Z","timestamp":1738133782000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Microsurgical Reconstruction of Complex Scalp Defects With Vastus Lateralis Free Flap"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0319-0906","authenticated-orcid":false,"given":"Giovanni","family":"Zabbia","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6563-7390","authenticated-orcid":false,"given":"Emanuele","family":"Cammarata","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5799-1461","authenticated-orcid":false,"given":"Mara","family":"Franza","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4903-815X","authenticated-orcid":false,"given":"Francesca","family":"Toia","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2870-7888","authenticated-orcid":false,"given":"Greta","family":"Tondini","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Graziano","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Head and Neck Surgery Garibaldi Hospital  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1685-5209","authenticated-orcid":false,"given":"Domenico Gerardo","family":"Iacopino","sequence":"additional","affiliation":[{"name":"Neurosurgical Clinic AOUP \u201cPaolo Giaccone\u201d, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5137-4294","authenticated-orcid":false,"given":"Adriana","family":"Cordova","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) 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