The Triple Rotation Scalp Flap Revisited: A Case of Reconstruction of Cicatricial Pressure Alopecia

    Ioannis George-Akrivos Michaelidis, Panagiotis K. Stefanopoulos, G.A. Papadimitriou
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    TLDR The triple rotation scalp flap technique successfully reconstructed a man's scalp with natural-looking hair growth and minimal scarring.
    The document describes a successful case of scalp reconstruction using the triple rotation scalp flap technique for a 23-year-old man who developed cicatricial pressure alopecia following a motorcycle accident and subsequent treatment in the ICU. The patient had a 6-cm bald patch with chronic focal ulceration, which was repaired under general anesthesia using the Bardach modification of the curved tripod flap. The procedure involved excising the affected area, elevating flaps in the subgaleal plane, and rotating them to close the defect. Four months postoperatively, the patient showed good hair growth with minimal scarring. The paper highlights the advantages of this technique, including the natural appearance of the final result due to the preservation of hair orientation and the distribution of wound-closure tension over a wide area, despite the need for extensive undermining. The triple rotation flap is emphasized as a beneficial option for managing cicatricial alopecia, particularly when microsurgical transfer techniques are not used.
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