AIM: The reconstruction of post-traumatic losses of substance of the scalp is very difficult due to the unique characteristics of the scalp. The purpose of this paper is to evaluate the results obtained with several techniques in order to identify the most appropriate. METHODS: We treated 19 patients, 11 men and 8 women aged between 19 and 81 years, with post-traumatic loss of substance of the scalp from January 2006 to June 2011. The chosen treatments were the direct closure and the use of local flaps, the latter combined or not with the graft of the donor area and the post-operative correction of alopecic area with tissue expansion. RESULTS: None of the patients developed severe complications and all flaps were viable. The aesthetic results were variable, between good and satisfactory according to the technique used. CONCLUSION: The local flaps represent a good choice for the treatment of post-traumatic losses of substance of the scalp, restricting the use of direct suture and the use of skin grafting only in selected cases. Tissue expansion is a good choice for the revision of alopecic and cicatricial areas.
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