Scalp reconstruction: regeneration with acellular dermal matrix.

BACKGROUND: Current methods of scalp reconstruction with complicating osteomyelitis of underlying bone require excision of deficient tissue and a staged reconstruction for ultimate coverage of the defect. Our group proposes a novel use of acellular dermal matrix (ADM) to preserve these deficient areas without the need for excision or staged management of osteomyelitic calvaria.

METHODS AND RESULTS: From 2003 to 2008, 3 patients underwent scalp reconstruction with ADM at our facility. Elevation of the scalp for secondary operations in each case showed full incorporation of the ADM. Follow-up ranging from 12 to 36 months showed a healed scalp with preserved hair-bearing skin in all cases.

CONCLUSIONS: Scalp regeneration with ADM has specific advantages that include preservation of hair-bearing scalp, maintenance of distinct tissue planes for later reconstruction, absence of a donor site, and the alleviation of tissue expansion. This technology may represent an immediate solution for difficult scalp defects that would otherwise require staged complex reconstruction.