Forehead defects are always challenging in the sense that skin cover along with cosmetic appearance has to be taken into account. This case-patient had an RTA skid and fall from the two-wheeler. The patient was assessed For GCS and taken up for surgery.
|Actual Defect Forehead|
Planning for a cover
The defect is assessed then it was noticed that the hair-bearing skin was lost. So what is important in this case is to have a cover as well as to have hair growing pattern maintained. So lateral to the defect advancement flap was planned and rotation was planned from the scalp to the forehead. Finally, a skin when hair would cover the defect.
|Defect after debridement|
Final inset and cover
First, two parallel incisions are made on the lateral aspect and minimal advancement is achieved covering part of the defect. then scalp half rotation is used to cover the remaining defect .note the three-point stitch is more important where the two flaps come together. suturing without tension is needed here. Finally, a drain was kept to avoid hematoma under the flap.
|Flap and Final Inset|