Temporal Vascularized Fascial Flap Combined With Bilayer Artificial Dermis for Scalp Reconstruction With Calvarial Exposure: A Bioengineering Strategy Integrating Angiogenesis and Dermal Regeneration

The reconstruction of traumatic scalp defects with skull exposure presents multifaceted challenges, including compromised vascular reconstruction, periosteal defects, and high aesthetic demands. This study reports the case of a 57-year-old female patient with a post-traumatic right temporal scalp defect and skull exposure after a traffic accident. A staged protocol involving negative pressure wound therapy, pedicled fascial flap transfer, and bilayer artificial dermis grafting achieved complete wound closure within 15 days. At the 8-month follow-up, the Vancouver Scar Scale score was 1, demonstrating optimal aesthetic and functional restoration. This approach synergizes the vascularization advantages of fascial flaps with the regenerative properties of artificial dermis, effectively addressing limitations of traditional methods-such as flap bulkiness and donor site morbidity-and offers a novel paradigm for skull exposure defect reconstruction.