Introduction

Facial and scalp reconstruction following wide tumor resection is a continuous challenge for Dermatologist and Plastic Surgeons. In fact, the extent of resection (sometimes the galea and the periosteum removal is needed), the risk of tumor recurrence, and the probable adjuvant or neoadjuvant radiation therapy are the fundamental clinical problems to be solved.
An optimal reconstruction should guarantee a successful coverage and protection of exposed planes, maintaining a soft-tissue bulk and contour, with good aesthetical outcomes.
Moreover, the surgical coverage must be related to different factors such as patient’s age, general status, clinical prognosis, type and side of the defect, the tissue surrounding the defect, adjuvant treatment, ability to care, and also cosmesis.
Skin grafts and local or free flaps (muscular, myocutaneous, myofascial, or fasciocutaneous) can be used for head reconstruction after oncologic demolition, but all present some disadvantages (as donor-site morbidity, significant long-lasting operative time and hospital stay, unstable results), especially in old patients with local advanced cancers, systemic diseases, or a prior history of recurring skin tumors.
So, when the autologous tissue cannot be used, the artificial dermis may provide a valid and reliable alternative with a low complication rate.
For more than 25 years, the artificial dermis has been successfully used in reconstructive surgery; up to now, however, there are still few reports of its use for reconstruction of complex facial and scalp defects, especially in older patients [1–7]. In particular, in the recent literature, there is no report of the use of Pelnac® (Gunze Corp., Osaka, Japan) in head reconstruction following skin cancer resection.
Te authors present their clinical series of 16 consecutive patients who underwent wide resection of skin cancer of the head and successful reconstruction using a new artificial dermis (Pelnac®) at the Plastic Surgery Department of the University of Foggia-Ospedali Riuniti, Foggia, Italy.
Te goal of this work is to explore the utility of this artificial dermis as a successful tool for postoncological reconstruction of wide and deep facial and scalp wounds, especially in older patients, that could not tolerate complex
reconstructive procedures in general anesthesia, or need adjuvant radiotherapy, analyzing the overall morbidity of the surgical technique and aesthetic outcomes.