ORIGINAL ARTICLES: PDF Only

Extensive Scalp Lifting: Decrease in Complications Utilizing Unilateral Occipital Artery Ligation and Other Modifications

SWINEHART, JAMES M. MD¹; GRIFFIN, EDMOND I. MD¹

¹ Department of Dermatology (JMS), University of Colorado Health Sciences Center, Denver, Colorado, and Emory University (EIG), Atlanta, Georgia.

Address correspondence and reprint requests to: James M. Swinehart, MD, 950 East Harvard Avenue, Suite 630, Denver, CO 80210.

The Journal of Dermatologic Surgery and Oncology 18(9):p 796-804, September 1992. | DOI: 10.1111/j.1524-4725.1992.tb03037.x

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Abstract

The superior yield from extensive scalp lifting has been detracted from by complications, including hemorrhage, scalp necrosis, and the need for greater anesthesia. Intraoperative unilateral occipital artery ligation, with extensive undermining to the nape of the neck on only one side, can minimize the risk of postoperative scalp necrosis or telogen effluvium. Careful hemostasis, extensive infusion of dilute anesthetic, and modifications in instrumentation can decrease the morbidity associated with this procedure. The advantages of the operation include removal of the large amounts of bald scalp, excellent intraoperative visualization, and lack of stretchback and asymmetry. J Dermatol Surg Oncol 1992;18:796–804.