More on skin cancers on scalp and pinwheel flaps

Skin Cancers on Scalp? Benefits of using a pinwheel flap

Often I see people who have had skin grafts on their scalp. They have had a skin cancer removed and then a  piece of skin taken from elsewhere has been placed in the hole. There are major disadvantages to this.

1. The skin graft often falls off.
2. The skin graft looks different. You will always have a bald spot.
3. There is another wound in the body where the graft was taken.

Therefore, where possible, I try to use a flap, meaning rotation of skin from surrounding the defect to fill the hole. The advantages of this are:

1. No bald spot.
2. Same color and skin thickness as the rest of the scalp
3. No separate wound and therefore less pain.

This unfortunate lady has a cancer measuring about 3 by 3 cm on the back of her head just above the ear.

A pinwheel flap has been designed. Four bits of skin are rotated to fill the defect created by excising the skin cancer.

The end result looks like this.

The really good thing is that in three months time, all the hair will have grown back and no scars will be seen. Unlike a skin graft, which will always present as a discoloured bald patch.

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