RECONSTRUCTION OF THE SCALP AFTER SKIN CANCER SURGERY

Reconstruction of the scalp poses unique challenges for the Mohs micrographic surgeon. Due to decreased laxity of the anatomic location, one must take an algorithmic approach to wound closure on the scalp, employing specialized techniques to facilitate faster healing. Unlike other aspects of the face, the scalp is largely devoid of major motor nerves and “danger zones.” This allows the surgeon to safely recruit from several directions simultaneously in order to close the wound. The layers of the scalp, from most external to deepest are the epidermis, dermis, adipose tissue, galea, pericranium, and bone (Fig. 1.1).