Incisioni della galea aponeurotica in lembi di cuoio capelluto avanzati per ricostruzioni loco-regionali

The aim of the present study was to evaluate how much a relaxing incision of the galea aponeurotica affects the biomechanical properties of a scalp flap to quantify the surgery-related advantages provided by this procedure. Twenty scalp flaps, created by a reverse-Y incision down and through the galea aponeurotica together with undermining (in the layer between the galea and the pericranium) to within 1 cm of the external auditory canal were studied. Data were collected by stepwise loading the scalp flaps before and after performing three full-thickness galeotomies lengthwise and parallel to the sagittal scalp incision. The tension/extension ratio characteristics were computed, and loading curves as well as mean stiffness values were measured. A statistically significant difference (-16.6 g per millimeter) was found between the slope (computed as Young's modulus) of the curve obtained before and after performing galeotomies. This values corresponded to a mean 40% reduction of the closing tension attained with each galeotomy. In the closing-tension interval 500 g to 1500 g, the mean gain of length of the scalp per galeotomies was 1.67 mm. These data confirm the usefulness of galeotomies for lengthening the scalp flaps and for diminishing the tension on wound margins when closing scalp defects.