Reconstruction of half of the forehead traumatic defect with single rotation flap and hemi-brow transposition in a resource constrained setting: -a case report-

Forehead reconstruction is very challenging due to limited availability of matching skin for coverage. This is even more challenging in acute traumatic events characterized by gross contamination, presence of open wounds and injury to surrounding tissues. The use of loco-regional flap option may be the only available resort where facility and expertise for free flaps are not adequate. We present a 50 year old lady that had traumatic avulsion of slightly over half of the forehead with an extension wound to the ipsi-lateral temporal region following road traffic accident. There were crushing of ipsi-lateral eye and periosteal stripping of the underlying bone. She had an immediate flap cover after resuscitation using a single rotation scalp flap based on the ipsi-lateral occipital, posterior auricular and superficial temporal arteries. The adjoining temporal region wound was covered with split-thickness skin graft. She had excellent flap survival and satisfactory graft take. We observed that this flap could be successfully used in the setting of trauma to transfer a like for skin in the setting of trauma. This is especially useful in resource constrained setting where free tissue transfer is still insufficiently used.