Background. This article describes an operative technique, based on the use of three galeal flaps anchoring, aimed at reducing the percentage of "stretchback" occurring after performing scalp reduction procedures. Methods. In 12 male patients undergoing a midline scalp reduction procedure, three rectangular galeal flaps, in direct continuity with the longitudinal margin of the left scalp flap, were sutured individually to the galeal undersurface of the right scalp flap to draw the two scalp flaps toward the midline of the scalp and to relieve the wound margins of closing tension. Tattoo marks were placed on the patient's scalp at the level of the vertical lines drawn through the external auditory meatuses (A1-A2) and 6 cm posteriorly (B1-B2). Results. The results were compared with those obtained from a control group of 13 male patients who underwent the same surgical procedure but without the use of the anchoring galeal flaps. Mean stretch-back at A1-A2 and B1-B2 levels was lower in the experimental group than in the control group with a statistically significant difference (p<0.005) between data from the two groups. The use of the described galeal flaps allowed us to obtain an 80.93 % and an 88.09 % stretch-back reduction at A1-A2 and B1-B2 levels, respectively, 1 month post-operatively. Conclusions. In personal opinion, our data indicate a positive cost/benefit ratio because this method optimizes the results obtainable by scalp reduction procedures and it may offer a solution to the deleterious effects of excessive tension along wound margins encountered when closing a scalp defect.
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