Outcomes of Tissue Expander Application for Scalp Reconstruction in Extensive Aplasia Cutis Congenita

The study reviewed the medical records of six patients with extensive Aplasia Cutis Congenita (ACC) who underwent scalp reconstruction using tissue expanders. The patients, with an average age of 14.5 years, were initially treated with split-thickness skin grafts and later received tissue expanders and scalp flap applications to correct alopecia and soft tissue defects. The mean follow-up period was 8.6 years, and the mean size of grafted areas was 69.5 cm². Complications were minimal, with only one case of distal flap necrosis and one expander removal due to infection. CT scans showed intact calvarium with patchy hyperostosis, and clinical examination revealed acceptable cosmetic results. The study concluded that late expander scalp reconstruction is a viable management strategy for extensive ACC, suggesting that early cranioplasty can be reserved for more complicated cases.