Staged reconstruction of an extensive oncologic scalp defect using two complementary dermal scaffolds and a cultured autologous skin equivalent: a case report
Abstract
Reconstruction of extensive oncologic scalp defects is challenging in older patients who are poor candidates for flap surgery. We report an 87-year-old woman who underwent wide excision of a 14 × 11 cm basal cell carcinoma, resulting in a 16 × 13 cm full-thickness scalp defect with partial calvarial exposure. The anterior wound was covered with a human acellular dermal matrix and the posterior wound with a bilayer collagen-glycosaminoglycan dermal regeneration template. After formation of a vascularised neodermis, the defect was resurfaced with a cultured autologous skin equivalent; a second application treated residual uncovered areas. Both scaffolds integrated. A localised Enterobacter cloacae infection resolved with susceptibility-guided oral levofloxacin. Progressive epithelialisation achieved complete, durable coverage with an acceptable contour and no further complications at 9 months. This staged strategy avoided flap surgery and extensive donor-site morbidity.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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