# Coverage of necrosis after secondary cranioplasty using a latissimus dorsi muscle flap

## TL;DR

A 70-year-old woman with health issues developed scalp necrosis after skull surgery and was successfully treated with a latissimus dorsi muscle flap.

## Contribution

Demonstrates successful use of latissimus dorsi flap for managing large cranial defects in patients with complex vascular conditions.

## Key findings

- Latissimus dorsi flap effectively reconstructed a large cranial defect with dural exposure.
- The patient's wound fully healed within 8 weeks without infection or recurrence of necrosis.
- Microvascular anastomosis using superficial temporal vessels was successfully performed.

## Abstract

Secondary cranioplasty aims to restore skull integrity after decompressive surgery but can be complicated by rare issues such as skin necrosis. We report a case of a 70-year-old female with multiple comorbidities who developed extensive scalp necrosis following cranioplasty. Surgical revision revealed significant dural exposure, requiring reconstruction with a free latissimus dorsi flap and a split-thickness skin grafting. Microvascular anastomosis was performed using the superficial temporal vessels. At 8-week follow-up, the site was fully healed without infection or recurrent necrosis. This case underscores the effectiveness of the latissimus dorsi free flap in managing large cranial defects, especially in patients with complex vascular conditions.