Double-free, flow-through flap reconstruction for complex scalp defects: a case report

This case report describes the use of a double-free, flow-through flap as a valuable tool in reconstruction following oncological resection of a large, fungating, squamous cell carcinoma extending through the scalp, forehead, skull, and dura. An anterolateral thigh flap was utilized to supply: soft tissue for the forehead reconstruction, vascularized fascia lata for the dural repair, and to act vascular conduit to supply a distally placed latissmus dorsi flap for total scalp reconstruction. We believe this is the first time this combination of double-free, flow-through flap design has been published for the reconstruction of complex, composite scalp and calvarial defects.