Epidemiological Aspect and Management of Loss of Substance from the Scalp according to the Experience of the Plastic Surgery Department of Marrakech Morocco about 24 Cases

Scalp defects pose significant reconstructive challenges due to their complex anatomy and functional implications. This retrospective study analyzes 24 cases managed at our institution over 16 months (January 2020–April 2021), focusing on etiology, surgical techniques, and outcomes. Malignant tumors (83%)—primarily squamous cell carcinoma (n=12), basal cell carcinoma (n=4), and melanoma (n=3)—were the leading cause, with a male predominance (sex ratio 9.5) and mean age of 60.3 years. Defects averaged 9 cm, most commonly parietal (75%). Reconstruction employed local flaps (n=16), skin grafts (n=11), or direct suture (n=2), with cranial flaps required in 9 cases. Delayed presentation (mean 14 months) and traditional pre-treatment (20% of cases) correlated with poorer outcomes. Local flaps, particularly rotation flaps based on temporal/occipital arteries, provided optimal results due to their vascular reliability and single-stage execution. No distant flaps were utilized. Our findings underscore the need for early intervention and highlight the efficacy of locoregional flaps in resource-limited settings.