PMC5917313_01
Patient presentation with large open wound.
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A 76-year-old Caucasian man was referred to our institution for evaluation of a large open scalp wound, secondary to excision and prior radiation of squamous cell carcinoma (SCC) of the left temporal scalp (Figure 1).
Surgical excision and craniectomy.
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He underwent surgical excision of the defect, including craniectomy, due to apparent involvement of the dura (Figure 2).
Patient marked for harvest of left latissimus dorsi flap.
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A left latissimus dorsi myocutaneous flap was harvested for coverage of the defect (Figure 3).
Flap inset and coverage by full-thickness skin graft.
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The muscle flap was inset and the full-thickness skin graft, taken from the original donor site, was chosen to cover the free flap (Figure 4).
Pigmented lesion within central area of skin graft overlying the latissimus flap.
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Approximately 19 months following his free flap reconstruction, a pigmented lesion located centrally within the skin graft overlying the flap was discovered (Figure 5).