Prevention of Venous Congestion in Superficial Temporal Artery Pedicled Scalp Flaps Using Deep Temporal Fascia

Background: Venous congestion is an important complication in superficial temporal artery pedicled scalp flaps. In this study, we added deep temporal fascia, including the middle temporal vein, to the flap pedicle to prevent venous congestion in these flaps. Methods: A horn-shaped superficial temporal artery pedicled scalp flap was used to repair scalp and facial defects in 16 patients with a mean age of 52 years. The flaps were raised together with the superficial and deep temporal fascia at the base of the pedicle. The flap sizes ranged from 9 × 4 cm to 23 × 7 cm, and the mean follow-up period was seven months. Results: Venous congestion did not develop in any of the flaps. Abnormal hair distribution developed in three patients and hematoma in one patient. In all of the patients, the donor site was closed primarily and there was no flap loss. Conclusions: In scalp flaps with a superficial temporal artery pedicle, venous congestion can be prevented, and elevated more safely by adding a deep temporal fascia to the flap pedicle.