An algorithmic approach to scalp reconstructive surgery: maximization of cosmetic and functional outcomes

The review outlines an algorithmic approach to scalp reconstructive surgery, focusing on achieving optimal cosmetic and functional outcomes by considering defect location, size, and local scalp anatomy. It categorizes defects into small (<3 cm), moderate (3-5 cm), and large (>5 cm), providing specific guidelines for each. Small defects often require primary closure, moderate defects may need advancement or rotation flaps, and large defects might necessitate complex procedures like tissue expansion or free tissue transfer. The review emphasizes using local scalp tissue to maintain cosmetic integrity and minimize complications such as alopecia and color mismatch. Techniques vary based on defect size and patient needs, with options for extreme cases including various free tissue transfer methods.