Calvarial and Scalp Reconstruction

Scalp reconstruction involves nearly the entire spectrum of reconstructive surgery, including skin grafting, local flaps, and microvascular free flaps. Additionally, tissue expansion can play important role in maximizing outcomes. In recent years, reconstructive algorithms specific to scalp reconstruction have been developed that consider not only the size of the defect, but the quality of local tissues.  Many materials have been used for calvarial reconstruction and most modern alloplasts are as reliable as autologous bone, although each as its own advantages and disadvantages.  Simultaneous scalp and calvarial reconstruction is now routinely performed.  Remaining challenges include management of wound complications over alloplasts and of the infected cranial bone flap following neurosurgical procedures. This review contains 15 figures, 5 tables, and 41 references. Keywords: scalp, calvarium, cranioplasty, free flap, tissue expander, skin graft, bone graft, titanium mesh, methylmethacrylate, polyetheretherketone (PEEK)