The degree of deformity generally determines the treatment choice. Advancements in HRS in the past 2 decades are significant in yielding natural and almost undetectable results. Using a combination of HRS and cosmetic and reconstructive techniques, most deformities can be treated effectively.
- Planning is critical. Patient/family counseling regarding temporary deformity is crucial.
- It is best to overestimate the needed expansion and choose the largest commercially available expander that fits the patient’s anatomy.
- The vertical dimension is the most important factor providing the greatest gain in flap expansion. When the distance over the expanded tissue minus the base width of the expander is equal to 120% of the defect width, the expansion is complete.
- Overexpansion even by a modest amount will increase patient safety by providing excess tissue to cover the defect, allowing closure with minimal or no tension.
- If the entire defect cannot be removed and the residual defect is significant, leave the expander in place for a second expansion.
Scalp Avulsion Injuries