Review Article: Post-Trauma Scalp Reconstruction

Traumatic scalp injuries represent a significant challenge in plastic and reconstructive surgery due to the anatomical complexity of the region and the need to restore both protective function and aesthetics. The scalp, composed of multiple layers (skin, subcutaneous tissue, galea aponeurotica, loose areolar tissue, and pericranium), is a richly vascularized structure that protects the skull and brain. Defects resulting from trauma can vary in size and depth, from small lacerations to extensive avulsions that expose the cranial bone, compromising structural and functional integrity, and severely affecting the patient's quality of life [1, 3, 9]. Successful post-trauma scalp reconstruction not only aims to close the defect but also to restore protective coverage, preserve hair function, and achieve an acceptable aesthetic outcome. Over the years, various surgical techniques have been developed, ranging from primary closure and skin grafts to the use of local, regional, and microvascularized flaps, as well as tissue expansion and the use of dermal substitutes [1, 4, 7, 8, 12]. The choice of the optimal reconstructive technique depends on multiple factors, including the size and location of the defect, the presence of healthy surrounding tissue, bone exposure, the patient's age and comorbidities, and the surgeon's experience [3, 10, 12]. This systematic review article aims to provide an updated overview of contemporary techniques in post-trauma scalp reconstruction. It focuses on the most recent and relevant medical literature published in plastic surgery journals over the last 5 to 8 years, in order to synthesize surgical innovations, treatment algorithms, and reported outcomes. This review seeks to be a comprehensive guide for medical professionals and researchers interested in the advanced management of traumatic scalp defects, contributing to the improvement of reconstructive strategies and, ultimately, to the optimization of patient outcomes.