Dual Transposition Flaps for the Reconstruction of Large Scalp Defects

The article discusses a case study of a man with a large scalp defect resulting from Mohs surgery for a basal cell carcinoma. The authors present a dual transposition flap technique for closing the wound, which resulted in minimal alopecia, minimal distortion of hair orientation, and minimal scar stretch-back. The technique involves using two anteroposterior oriented parieto-occipital transposition flaps, which were staged as two separate operations spaced two weeks apart to minimize stretch-back and tension across suture lines. The authors conclude that this technique is a good reconstructive option for large, immobile scalp defects with minimal alopecia and camouflaged scars.